Provider Demographics
NPI:1003845744
Name:BUI, KIEM THI (RPH)
Entity Type:Individual
Prefix:MS
First Name:KIEM
Middle Name:THI
Last Name:BUI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16013 MUIRFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-2861
Mailing Address - Country:US
Mailing Address - Phone:813-926-4441
Mailing Address - Fax:
Practice Address - Street 1:1300 BRUCE B DOWNS BLVD
Practice Address - Street 2:13000
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9217
Practice Address - Country:US
Practice Address - Phone:813-926-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 345687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist