Provider Demographics
NPI:1033314703
Name:NGUYEN, MY HANH T (MD)
Entity Type:Individual
Prefix:
First Name:MY HANH
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 BOSTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-4798
Mailing Address - Country:US
Mailing Address - Phone:407-775-7654
Mailing Address - Fax:407-834-6082
Practice Address - Street 1:7975 LAKE UNDERHILL RD.
Practice Address - Street 2:SUITE 230
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8204
Practice Address - Country:US
Practice Address - Phone:407-281-0866
Practice Address - Fax:407-281-9288
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100058207W00000X
FLME101560207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A100580Medicaid
CA0A1000580OtherMEDICAL PIN
FL000191100Medicaid
FLFN0312746OtherDEA
CA00A100580Medicaid
FLBE126YMedicare PIN
FL000191100Medicaid