Provider Demographics
NPI:1851505283
Name:TRAN, NGHIA XUONG (OD)
Entity type:Individual
Prefix:
First Name:NGHIA
Middle Name:XUONG
Last Name:TRAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4606
Mailing Address - Country:US
Mailing Address - Phone:407-649-0055
Mailing Address - Fax:407-649-1889
Practice Address - Street 1:818 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4606
Practice Address - Country:US
Practice Address - Phone:407-649-0055
Practice Address - Fax:407-649-1889
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 2786152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOPC2786OtherCERTIFY OPTOMETRIST
U90227Medicare UPIN