Provider Demographics
NPI:1336404342
Name:HO, THANH THAO THI (OD)
Entity Type:Individual
Prefix:DR
First Name:THANH THAO
Middle Name:THI
Last Name:HO
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 1:1922 GREYSTONE TRL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-4784
Mailing Address - Country:US
Mailing Address - Phone:407-230-3663
Mailing Address - Fax:
Practice Address - Street 1:3968 SW ARCHER RD # W101
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-2342
Practice Address - Country:US
Practice Address - Phone:352-376-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002634152W00000X
FLOPC 4748152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist