Provider Demographics
NPI:1770599672
Name:VUONG-HUYNH, LANNIE (MD)
Entity type:Individual
Prefix:
First Name:LANNIE
Middle Name:
Last Name:VUONG-HUYNH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LANNIE
Other - Middle Name:
Other - Last Name:VUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11645 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3155
Mailing Address - Country:US
Mailing Address - Phone:305-538-8835
Mailing Address - Fax:954-538-1794
Practice Address - Street 1:11645 BISCAYNE BLVD
Practice Address - Street 2:SUITE 103-104
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3155
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:305-891-3496
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78327208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL259614800Medicaid
FL35897NMedicare PIN