Provider Demographics
NPI:1316547920
Name:HUYNH, MICHELLE DAWN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DAWN
Last Name:HUYNH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 ORANGE HILL DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2602
Mailing Address - Country:US
Mailing Address - Phone:813-215-3605
Mailing Address - Fax:
Practice Address - Street 1:2140 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6210
Practice Address - Country:US
Practice Address - Phone:813-681-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-01
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist