Healthcare Provider Details

I. General information

NPI: 1164284592
Provider Name (Legal Business Name): AN HUYNH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16695 SE 91 ST PHILLIPS CT
THE VILLAGES FL
32162
US

IV. Provider business mailing address

16695 SE 91 ST PHILLIPS CT
THE VILLAGES FL
32162
US

V. Phone/Fax

Practice location:
  • Phone: 253-286-8424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24058
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70715
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: