Individual provider · NPI-1

Jeremy Hoa Bui, CAA

Anesthesiologist Assistant · Tallahassee, FL

NPI number1801458021
StatusActive
Last updated in NPPESAug 5, 2024

Details

NPI
1801458021
Entity type
Individual (NPI-1)
Name
Jeremy Hoa Bui
Credential
CAA
Sex
Male
Sole proprietor
No
Enumeration date
Jul 8, 2019
Certification date
Aug 5, 2024
Last updated
Aug 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367H00000X Anesthesiologist Assistant10559GAYes
367H00000X Anesthesiologist Assistant––

Practice location

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Phone 470-554-6840

Mailing address

3575 Mount Vernon Ct
Lawrenceville, GA 30044-3105

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