Provider Demographics
NPI:1588950265
Name:NGUYEN-MIN, CAROLINE NU (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:NU
Last Name:NGUYEN-MIN
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 1:3464 AVALON PARK EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7363
Mailing Address - Country:US
Mailing Address - Phone:407-635-3020
Mailing Address - Fax:321-203-4607
Practice Address - Street 1:3464 AVALON PARK EAST BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-7363
Practice Address - Country:US
Practice Address - Phone:407-635-3020
Practice Address - Fax:321-203-4607
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118920207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012187300Medicaid
FLME118920OtherMEDICAL LICENSE
FL012187300Medicaid