Healthcare Provider Details

I. General information

NPI: 1194651869
Provider Name (Legal Business Name): HUY HONG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5245 BABCOCK ST NE BAY FL32905
PALM BAY FL
32905-4601
US

IV. Provider business mailing address

1400 BERRYHILL DR
MELBOURNE FL
32934-7258
US

V. Phone/Fax

Practice location:
  • Phone: 321-409-1148
  • Fax:
Mailing address:
  • Phone: 774-525-9298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS57440
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: