Individual
MS. ANH MY PHUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1510 E FOWLER AVE, TAMPA, FL 33612-5416
(813) 971-0471
(813) 464-2763
Mailing address
1005 LYNDHURST WAY SE, CONYERS, GA 30013-2999
(770) 891-0683
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5405
FL
152W00000X
Optometrist
OPT002670
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021625600
—
FL
Enumeration date
10/06/2011
Last updated
07/21/2022
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