Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 4783 | FL |
N | 152W00000X | Optometrist | 7991TG | TX |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 4783 | FL |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 4783 | FL |
Y | 152WP0200X | Pediatric Optomitrist | 4783 | FL |
NPI | 1043575228 |
---|---|
Provider Name | Dr. Anthony T Huynh |
First Address | Orlando, FL 32825-7801 |
Second Address | Orlando, FL 32825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2012 |
Last Update Date | 20/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00E63G | (02) | TX |
1124091-04 | (05) | TX |
HQ361Z | (02) | FL |