Healthcare Provider Details

I. General information

NPI: 1053246603
Provider Name (Legal Business Name): JANNIE QUYNH HO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 SE 18TH AVE
OCALA FL
34471-8312
US

IV. Provider business mailing address

1910 SE 18TH AVE
OCALA FL
34471-8312
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-8544
  • Fax:
Mailing address:
  • Phone: 727-688-7986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN31931
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: