Provider Demographics
NPI:1730380478
Name:NGUYEN, MICHAEL (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2020 PONCE DE LEON BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4474
Mailing Address - Country:US
Mailing Address - Phone:786-618-5039
Mailing Address - Fax:305-397-2227
Practice Address - Street 1:2020 PONCE DE LEON BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4474
Practice Address - Country:US
Practice Address - Phone:786-618-5039
Practice Address - Fax:305-397-2227
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN10915207R00000X
MA245841207LP2900X
FLME-116391207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine