Provider Demographics
NPI:1316908668
Name:NGUYEN, MY-DUC THI (MD)
Entity type:Individual
Prefix:DR
First Name:MY-DUC
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2600 WESTHALL LANE
Mailing Address - Street 2:BOX 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-200-2807
Mailing Address - Fax:407-200-1353
Practice Address - Street 1:2301 SAND LAKE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7639
Practice Address - Country:US
Practice Address - Phone:407-851-6478
Practice Address - Fax:407-240-1970
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GU174400000X
FLME 64633207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist