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General NPI Number Information
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NPI Number | 1790188191
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Entity Type | Organization
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Legal Business Name | NHU EYES, LLC
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Dates
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Enumeration Date | 09/30/2014
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 430 E ALTAMONTE DR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4660
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Country | US
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Telephone | 407-830-5516
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Fax |
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Provider Business Mailing Address
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Address Line | 430 E ALTAMONTE DR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-4660
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Country | US
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Telephone | 407-830-5516
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | QUYNH PHAM
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Credential | O.D.
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Telephone | 407-587-9404
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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 | OPC 4906
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License Number State | FL
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