Provider Demographics
NPI:1043262173
Name:JOHN V TRAN DPM MPH PA
Entity type:Organization
Organization Name:JOHN V TRAN DPM MPH PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:VAN
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, MPH
Authorized Official - Phone:813-685-6922
Mailing Address - Street 1:1462 OAKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4853
Mailing Address - Country:US
Mailing Address - Phone:813-685-6922
Mailing Address - Fax:813-685-8308
Practice Address - Street 1:1462 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4853
Practice Address - Country:US
Practice Address - Phone:813-685-6922
Practice Address - Fax:813-685-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3132213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDE6361OtherRAILROAD MEDICARE
FL5736880001Medicare NSC
FLDE6361OtherRAILROAD MEDICARE