MEDICARE: MRS. HEIDI FIORELLA HUYNH PHARMD

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	183500000X	Pharmacist	PS42684	FL

General Provider Information

NPI Number	:	1508148503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEIDI FIORELLA HUYNH PHARMD

Provider Business Mailing Address
First Line	:	569 COPPERDALE AVE
Second Line	:
City	:	WINTER GARDEN
State	:	FL
Zip	:	34787-4500
Country	:	US
Telephone Number	:	786-859-9350
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 TECHNOLOGY PARK STE 158
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-6205
Country	:	US
Telephone Number	:	866-842-2147
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2011
Last Update Date	:	05/22/2023

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