Healthcare Provider Details

I. General information

NPI: 1700888112
Provider Name (Legal Business Name): HUY NGUYEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 KENCHESTER LOOP
WESLEY CHAPEL FL
33543-5111
US

IV. Provider business mailing address

6970 W. PATRICK LANE SUITE 140
LAS VEGAS NV
89113-0270
US

V. Phone/Fax

Practice location:
  • Phone: 702-450-1717
  • Fax:
Mailing address:
  • Phone: 702-450-1717
  • Fax: 702-947-6740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number11525
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: