Provider Demographics
NPI:1265701833
Name:HUYNH, TAM ANH (RPH, PHARM D)
Entity type:Individual
Prefix:DR
First Name:TAM
Middle Name:ANH
Last Name:HUYNH
Suffix:
Gender:M
Credentials:RPH, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 W KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-6138
Mailing Address - Country:US
Mailing Address - Phone:407-292-4623
Mailing Address - Fax:407-292-4886
Practice Address - Street 1:2814 W KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-6138
Practice Address - Country:US
Practice Address - Phone:407-292-4623
Practice Address - Fax:407-292-4886
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42027183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist