Provider Demographics
NPI:1124289129
Name:NGO, MINH B (MD)
Entity type:Individual
Prefix:DR
First Name:MINH
Middle Name:B
Last Name:NGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 MCMULLEN BOOTH RD
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6607
Mailing Address - Country:US
Mailing Address - Phone:727-725-6905
Mailing Address - Fax:727-266-4931
Practice Address - Street 1:3231 MCMULLEN BOOTH RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6607
Practice Address - Country:US
Practice Address - Phone:727-725-6526
Practice Address - Fax:727-266-4931
Is Sole Proprietor?:No
Enumeration Date:2008-06-23
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106263207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004047500Medicaid
FLP01010985OtherMEDICARE RAILROAD PROVIDER NUMBER
FLP01010985OtherMEDICARE RAILROAD PROVIDER NUMBER
FLFI277ZMedicare PIN