Provider Demographics
NPI:1013296508
Name:NGUYEN, LANH THI (OD)
Entity Type:Individual
Prefix:
First Name:LANH
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18246 SW 26TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-5149
Mailing Address - Country:US
Mailing Address - Phone:786-877-2493
Mailing Address - Fax:
Practice Address - Street 1:555 E 25TH ST
Practice Address - Street 2:#201
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3848
Practice Address - Country:US
Practice Address - Phone:305-691-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4617152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist