Healthcare Provider Details

I. General information

NPI: 1649905142
Provider Name (Legal Business Name): RITA HUYNH OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 N DALE MABRY HWY
TAMPA FL
33607-2551
US

IV. Provider business mailing address

3188 SHORELINE DR
CLEARWATER FL
33760-1736
US

V. Phone/Fax

Practice location:
  • Phone: 813-262-1096
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC6142
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number009598
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: