Provider Demographics
NPI:1639448897
Name:HUYNH, TRUC
Entity Type:Individual
Prefix:
First Name:TRUC
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2132 GREYSTONE TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-4766
Mailing Address - Country:US
Mailing Address - Phone:407-968-7913
Mailing Address - Fax:
Practice Address - Street 1:15507 STONEYBROOK WEST PKWY
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4734
Practice Address - Country:US
Practice Address - Phone:407-905-4044
Practice Address - Fax:407-905-4047
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-17
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36079183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist