Phan, Vincent Dong
Phan, Vincent Dong is an individual health care provider with primary practice located at 1350 Hickory St , Melbourne FL 32901-3224. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Phan, Vincent Dong can be contacted via phone (321) 434-1771.Contact Information
Primary practice address
1350 Hickory St
Melbourne FL 32901-3224
Phone: (321) 434-1771
Fax: (321) 434-1775
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME122707 | Florida |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME122707 | Florida |
Profile Details
| NPI number | 1083973150 |
|---|---|
| LBN Legal business name | Phan, Vincent Dong |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2012 |
| Last updated | Mar 11th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083973150 | NPPES |
| Florida | Other | P02395742 | FL RR MEDICARE |
| Florida | Other | IH482W | FL RR MEDICARE |
| Florida | MEDICAID | 015599300 | FL RR MEDICARE |
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