Provider Demographics
NPI:1841314739
Name:HUYNH-NGUYEN, ANN (OD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:HUYNH-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 1:1334 N KYLE WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-1927
Mailing Address - Country:US
Mailing Address - Phone:832-754-8310
Mailing Address - Fax:
Practice Address - Street 1:9041 SOUTHSIDE BLVD STE A
Practice Address - Street 2:TARGET OPTICAL
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-5484
Practice Address - Country:US
Practice Address - Phone:904-519-5057
Practice Address - Fax:904-519-2833
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4447152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist