MEDICARE: OANH HOANG OD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC4613	FL

General Provider Information

NPI Number	:	1114288420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OANH HOANG OD LLC

Provider Business Mailing Address
First Line	:	1486 NEWHAVEN POINT LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-6623
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1486 NEWHAVEN POINT LN
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-6623
Country	:	US
Telephone Number	:	561-596-6790
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OANH HOANG
Credential	:	OD
Telephone Number	:	561-596-6790

Provider Enumeration Date	:	06/04/2012
Last Update Date	:	06/04/2012

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