Basic Information
| Provider Information | |||||||||
| NPI: | 1043532377 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NGUYEN | ||||||||
| FirstName: | TOAN | ||||||||
| MiddleName: | THIEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1324 LAKELAND HILLS BLVD. | ||||||||
| Address2: | ATTN MANAGED CARE DEPT | ||||||||
| City: | LAKELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33805 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3525 LAKELAND HILLS BLVD # D | ||||||||
| Address2: | |||||||||
| City: | LAKELAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 338051965 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8636036565 | ||||||||
| FaxNumber: | 8636036554 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2010 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 266149 | NY | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | ME133482 | FL | N | Allopathic & Osteopathic Physicians | Surgery | 282N00000X | N | Hospitals | General Acute Care Hospital | 2086X0206X | ME133482 | FL | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology |
No ID Information.