Provider Demographics
NPI:1912335449
Name:NGUYEN, NGOC-UYEN THI (OD)
Entity Type:Individual
Prefix:
First Name:NGOC-UYEN
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 1:4652 MILLENIA PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-2434
Mailing Address - Country:US
Mailing Address - Phone:407-363-7833
Mailing Address - Fax:
Practice Address - Street 1:4652 MILLENIA PLAZA WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-2434
Practice Address - Country:US
Practice Address - Phone:407-363-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-18
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002287152W00000X
FLOPC4892152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist