Individual provider Active NPI

Candy Vo Tran

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1558027680
Registry record updated Mar 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9114496 Issued in FL
Practice address
832 W Central Blvd
Orlando, FL 32805-1809
Phone
(407) 858-1437
NPI assigned
Nov 12, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Florida State University College of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4052 Bald Cypress Way
Tallahassee, FL 32399-7017

6101 Lake Ellenor Dr
Orlando, FL 32809-4616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220318000739 FL Practitioner - Physician Assistant 8224423769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Dec 4, 2021 Accepting new patients
Florida Department of Health CurrentSince Dec 4, 2021 Accepting new patients

Locations

6101 Lk Ellenor Dr
Orlando, FL 32809
Phone (407) 723-5029

832 W Central Blvd
Orlando, FL 32805
Phone (407) 836-2619

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9114496 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

832 W Central Blvd
Orlando, FL 32805-1809

Mailing address

1742 Balsam Willow TRL
Orlando, FL 32825-4474
Phone (850) 225-0375

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
112530300MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 28, 2022.

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1558027680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 BALSAM WILLOW TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254474",
            "telephone_number": "850-225-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 W CENTRAL BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051809",
            "telephone_number": "407-858-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "CANDY",
        "middle_name": "VO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2022-03-28",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9114496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112530300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.