Provider Demographics
NPI:1811928237
Name:NGUYEN, HANSON (MD)
Entity type:Individual
Prefix:DR
First Name:HANSON
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DONG
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2037 E IRLO BRONSON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4416
Mailing Address - Country:US
Mailing Address - Phone:407-749-8877
Mailing Address - Fax:855-633-7729
Practice Address - Street 1:2037 E IRLO BRONSON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4416
Practice Address - Country:US
Practice Address - Phone:407-288-8157
Practice Address - Fax:855-633-7729
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME95889OtherMEDICAL LICENSE