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General NPI Number Information
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NPI Number | 1669751046
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Entity Type | Organization
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Legal Business Name | LANH NGUYEN OD AND ASSOCIATES LLC
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/16/2011
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Provider Practice Location Address
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Address Line | 555 E 25TH ST
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City | HIALEAH
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State | FL
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Zip | 33013-3848
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Country | US
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Telephone | 786-877-2493
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Fax |
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Provider Business Mailing Address
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Address Line | 18246 SW 26TH CT
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City | MIRAMAR
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State | FL
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Zip | 33029-5149
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Country | US
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Telephone | 786-877-2493
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | LANH THI NGUYEN
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Credential | O.D.
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Telephone | 786-877-2493
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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 | OPL4617
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License Number State | FL
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