Provider Demographics
NPI:1962585802
Name:BUI, DAVID QUANG (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:QUANG
Last Name:BUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4234
Mailing Address - Country:US
Mailing Address - Phone:407-895-3407
Mailing Address - Fax:407-898-8000
Practice Address - Street 1:700 N HAMPTON AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4234
Practice Address - Country:US
Practice Address - Phone:407-895-3407
Practice Address - Fax:407-898-8000
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 60771207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373158800Medicaid
FLF67837Medicare UPIN