NGUYEN VU, MD, PA
Ambulatory Health at Volusia Ave, Orange City, FL

License number
Florida ME109751
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. NGUYEN VU M.D.
Title: PRESIDENT
Phone: (317) 506-3525
Address
Address
1656 S Volusia Ave, Orange City, FL 32763
National Provider ID: 1659644987
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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NGUYEN VU, M.D., PA

Orange City, FL

Status:
Inactive
Doing business as:
Nguyen Vu MD
Inactive reason:
AMENDMENT AND NAME CHANGE
Registration:
Aug 22, 2011
Inactive since:
Dec 5, 2011
Phone:
(386) 917-0007 (Phone)
Addresses:
1656 S Volusia Ave, Orange City, FL 32763 (Physical)
1656 S Colusia Ave, Orange City, FL 32763
State ID:
P11000074974
Business type:
Florida Profit Corporation
Vice Presidents:
Nguyen M.d. Vu (President), 1656 S Volusia Ave, Orange City, FL 32763 (Physical),Van, Ha Vy T, Dc, 1656 S Volusia Ave, Orange City, FL 32763 (Physical),Ha D. Van (Vice President)
Agent:
Van, Ha Vy,1656 S Volusia Ave, Orange City, FL 32763 (Physical)
EIN:
90-0757477

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