Provider Demographics
NPI:1316921935
Name:TRAN, LONG V (MD)
Entity type:Individual
Prefix:DR
First Name:LONG
Middle Name:V
Last Name:TRAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2007 PALM BEACH LAKES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6501
Mailing Address - Country:US
Mailing Address - Phone:561-420-8555
Mailing Address - Fax:561-420-8550
Practice Address - Street 1:4714 OKEECHOBEE BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-4626
Practice Address - Country:US
Practice Address - Phone:561-332-4233
Practice Address - Fax:561-640-7506
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2022-05-05
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Provider Licenses
StateLicense IDTaxonomies
FL0060439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103650400Medicaid
FL377449000Medicaid
NC7615042Medicaid
FLE57028Medicare UPIN
23401Medicare ID - Type Unspecified