Healthcare Provider Details

I. General information

NPI: 1356192587
Provider Name (Legal Business Name): NGOC HUONG HELEN HO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 GREENWAY TRL
SANTA ROSA BEACH FL
32459-5589
US

IV. Provider business mailing address

361 GREENWAY TRL
SANTA ROSA BEACH FL
32459-5589
US

V. Phone/Fax

Practice location:
  • Phone: 850-892-8015
  • Fax: 850-892-8457
Mailing address:
  • Phone: 850-892-8015
  • Fax: 850-892-8457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: