Healthcare Provider Details

I. General information

NPI: 1760313456
Provider Name (Legal Business Name): THUY-HAN GABRIELLE NGUYEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABBY NGUYEN

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8224 S TAMIAMI TRL
SARASOTA FL
34238-2931
US

IV. Provider business mailing address

PO BOX 993
SEFFNER FL
33583-0993
US

V. Phone/Fax

Practice location:
  • Phone: 941-277-9021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6966
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: