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General NPI Number Information
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NPI Number | 1114190204
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Entity Type | Organization
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Legal Business Name | DR PAULINE L NGUYEN O D & ASSOCIATES P A
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 06/27/2011
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Provider Practice Location Address
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Address Line | 3020 LAMBERTON BLVD SUITE 107
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City | ORLANDO
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State | FL
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Zip | 32825
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Country | US
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Telephone | 407-780-6546
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Fax |
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Provider Business Mailing Address
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Address Line | 10040 SAVANNAH BLUFF LANE
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City | ORLANDO
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State | FL
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Zip | 32829
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Country | US
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Telephone | 407-780-6546
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. PAULINE LAM NGUYEN
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Credential | O D
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Telephone | 407-780-6546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC004095
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License Number State | FL
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