Healthcare Provider Details

I. General information

NPI: 1770599672
Provider Name (Legal Business Name): LANNIE VUONG-HUYNH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LANNIE VUONG M.D.

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11645 BISCAYNE BLVD SUITE 103-104
NORTH MIAMI FL
33181-3155
US

IV. Provider business mailing address

11645 BISCAYNE BLVD SUITE 207
NORTH MIAMI FL
33181-3155
US

V. Phone/Fax

Practice location:
  • Phone: 305-538-8835
  • Fax: 305-891-3496
Mailing address:
  • Phone: 305-538-8835
  • Fax: 954-538-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME78327
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: