Provider Demographics
NPI:1396571832
Name:NGUYEN, ANNDY (PA-C)
Entity type:Individual
Prefix:
First Name:ANNDY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2590 HEALING WAY STE 220
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-5496
Mailing Address - Country:US
Mailing Address - Phone:866-337-4251
Mailing Address - Fax:
Practice Address - Street 1:2590 HEALING WAY STE 220
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5496
Practice Address - Country:US
Practice Address - Phone:866-337-4251
Practice Address - Fax:847-381-8999
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9119185363A00000X
FL9119185363AS0400X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical