Provider Demographics
NPI:1750804175
Name:HO, CHIEU QUYNH (PA-C)
Entity type:Individual
Prefix:
First Name:CHIEU
Middle Name:QUYNH
Last Name:HO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 19TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-3020
Mailing Address - Country:US
Mailing Address - Phone:727-251-5018
Mailing Address - Fax:
Practice Address - Street 1:8875 HIDDEN RIVER PKWY STE 500
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637-2102
Practice Address - Country:US
Practice Address - Phone:866-337-4251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant