Provider Demographics
NPI:1346500329
Name:NGUYEN, DAT M (PHARMD, CPH)
Entity Type:Individual
Prefix:DR
First Name:DAT
Middle Name:M
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6206 N LOCKWOOD RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2529
Mailing Address - Country:US
Mailing Address - Phone:941-952-3959
Mailing Address - Fax:941-706-4254
Practice Address - Street 1:6206 N LOCKWOOD RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2529
Practice Address - Country:US
Practice Address - Phone:941-952-3959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU6305183500000X
FLPS40481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist