Healthcare Provider Details

I. General information

NPI: 1114281441
Provider Name (Legal Business Name): VU LE NHAT HO D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 1ST ST S
WINTER HAVEN FL
33880-4306
US

IV. Provider business mailing address

1500 1ST ST S
WINTER HAVEN FL
33880-4306
US

V. Phone/Fax

Practice location:
  • Phone: 682-433-1293
  • Fax:
Mailing address:
  • Phone: 682-433-1293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN25745
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: