Provider Demographics
NPI:1730417981
Name:DR NGO MEDICAL CLINIC PA
Entity type:Organization
Organization Name:DR NGO MEDICAL CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HUNG
Authorized Official - Middle Name:Q
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-412-5936
Mailing Address - Street 1:PO BOX 1515
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-1515
Mailing Address - Country:US
Mailing Address - Phone:407-412-5936
Mailing Address - Fax:407-601-0413
Practice Address - Street 1:5168 W COLONIAL DR
Practice Address - Street 2:SUITE 40
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7604
Practice Address - Country:US
Practice Address - Phone:407-412-5936
Practice Address - Fax:407-601-0413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-30
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty