Provider Demographics
NPI:1902879323
Name:TONG, ANN TRUONG (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:TRUONG
Last Name:TONG
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 1:4645 NW 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4524
Mailing Address - Country:US
Mailing Address - Phone:352-264-2500
Mailing Address - Fax:352-331-9095
Practice Address - Street 1:4645 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4524
Practice Address - Country:US
Practice Address - Phone:352-264-2500
Practice Address - Fax:352-331-9095
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11548207RC0000X
FLME 105109207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001176800Medicaid
NV100507586Medicaid
NV100507585Medicaid
NV100500023OtherNV MEDICAID
NVVWCHKLOtherNORIDIAN
FLCQ179ZMedicare PIN
NV100507586Medicaid
NV101774Medicare PIN