| Deerfield Beach Medical Clinic, P.a. | |
|
5300 W. Hillsboro Blvd. Suite 216 Coconut Creek FL 33073 | |
| (954) 725-8808 | |
| (954) 725-8818 |
| Full Name | Deerfield Beach Medical Clinic, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5300 W. Hillsboro Blvd., Coconut Creek, Florida |
| Authorized Official Name and Position | Nam Quoc Nguyen (PRESIDENT) |
| Authorized Official Contact | 9547258808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deerfield Beach Medical Clinic, P.a. 5300 W. Hillsboro Blvd. Suite 216 Coconut Creek FL 33073 Ph: (954) 725-8808 | Deerfield Beach Medical Clinic, P.a. 5300 W. Hillsboro Blvd. Suite 216 Coconut Creek FL 33073 Ph: (954) 725-8808 |
| NPI Number | 1275732414 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 01/09/2009 |
| Medicare PECOS PAC ID | 7719036664 |
|---|---|
| Medicare Enrollment ID | O20090522000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275732414 | NPI | - | NPPES |
| 000107864 | Other | HUMANA PROVIDER NUMBER | |
| H78725 | Medicaid | FL | |
| 264678100 | Medicaid | FL | |
| 51382 | Other | FL | BLUE CROSS BLE SHIELD PRO |
| 43340 | Other | NEIGBORHOOD HEALTH PROVID | |
| 145360 | Other | AETNA PRIVIDER NUMBER | |
| 289806 | Other | AVMED PROVIDER NUMBER | |
| P2789955 | Other | OXFORD HEALTH PLANS PROVI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS0008287 (Florida) | Primary |
| Provider Name | Nam Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598754970 PECOS PAC ID: 6901962059 Enrollment ID: I20090225000705 |
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