Provider Demographics
NPI:1508148503
Name:HUYNH, HEIDI FIORELLA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:FIORELLA
Last Name:HUYNH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:569 COPPERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4500
Mailing Address - Country:US
Mailing Address - Phone:786-859-9350
Mailing Address - Fax:
Practice Address - Street 1:100 TECHNOLOGY PARK STE 158
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-6205
Practice Address - Country:US
Practice Address - Phone:866-842-2147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42684183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist