Provider Demographics
NPI:1104952993
Name:VY, DUY (OD)
Entity type:Individual
Prefix:DR
First Name:DUY
Middle Name:
Last Name:VY
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 1:2933 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5041
Mailing Address - Country:US
Mailing Address - Phone:407-894-5441
Mailing Address - Fax:407-894-1282
Practice Address - Street 1:2933 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5041
Practice Address - Country:US
Practice Address - Phone:407-894-5441
Practice Address - Fax:407-894-1282
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3386152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL620743000Medicaid
FLU75434Medicare UPIN
FL620743000Medicaid