Provider Demographics
NPI:1942612148
Name:HUYNH, NAM (MD)
Entity Type:Individual
Prefix:
First Name:NAM
Middle Name:
Last Name:HUYNH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 DREW ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-315-7496
Mailing Address - Fax:
Practice Address - Street 1:10330 N DALE MABRY HWY STE 190
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4404
Practice Address - Country:US
Practice Address - Phone:813-969-4440
Practice Address - Fax:813-908-3290
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN19935207Q00000X
FLME128876207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine