=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033314703
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MY HANH T. NGUYEN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2007
-----------------------------------------------------
Last Update Date | 10/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4442 CURRY FORD RD
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32812-2741
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-281-0866
-----------------------------------------------------
Fax | 407-281-9288
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 160 BOSTON AVE
-----------------------------------------------------
City | ALTAMONTE SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32701-4798
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-775-7654
-----------------------------------------------------
Fax | 407-834-6082
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | A100058
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | ME101560
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------