Provider Demographics
NPI:1073298949
Name:HUYNH, LILY TRAN (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:LILY
Middle Name:TRAN
Last Name:HUYNH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6106 GREEN POND DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-5172
Mailing Address - Country:US
Mailing Address - Phone:904-422-6306
Mailing Address - Fax:
Practice Address - Street 1:1524 NORMANDY VILLAGE PKWY STE 32
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32221-7690
Practice Address - Country:US
Practice Address - Phone:904-482-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT40348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist