Individual
JIMMY LE NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
900 NW 17TH ST, MIAMI, FL 33136-1119
(305) 243-2020
Mailing address
900 NW 17TH ST, MIAMI, FL 33136-1119
(305) 243-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC5650
FL
152W00000X
Optometrist
Primary
OPT003314
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2019
Last updated
06/22/2021
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