Provider Demographics
NPI:1275871030
Name:NGUYEN, HUY TUAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:HUY
Middle Name:TUAN
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11701 BELCHER RD S STE 126
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-5117
Mailing Address - Country:US
Mailing Address - Phone:727-523-2515
Mailing Address - Fax:727-523-2536
Practice Address - Street 1:11701 BELCHER RD S STE 126
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5117
Practice Address - Country:US
Practice Address - Phone:727-523-2515
Practice Address - Fax:727-523-2536
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS42696OtherFLORIDA DEPARTMENT OF HEALTH