Provider Demographics
NPI:1528492899
Name:TRAN, ANNA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIE
Last Name:TRAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4717
Mailing Address - Country:US
Mailing Address - Phone:904-308-7372
Mailing Address - Fax:
Practice Address - Street 1:2627 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4717
Practice Address - Country:US
Practice Address - Phone:904-308-7372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2024-05-23
Deactivation Date:2019-03-04
Deactivation Code:
Reactivation Date:2021-07-20
Provider Licenses
StateLicense IDTaxonomies
374J00000X
FLUO7971390200000X
FLOS20813207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No374J00000XNursing Service Related ProvidersDoula
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program