Provider Demographics
NPI:1902968589
Name:NGO, HUAN (OD)
Entity Type:Individual
Prefix:
First Name:HUAN
Middle Name:
Last Name:NGO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11223 MADISON PARK DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-3996
Mailing Address - Country:US
Mailing Address - Phone:727-453-2260
Mailing Address - Fax:813-887-4031
Practice Address - Street 1:8220 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-2686
Practice Address - Country:US
Practice Address - Phone:813-887-4949
Practice Address - Fax:813-887-4031
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3931152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist