Provider Demographics
NPI:1346519022
Name:HUANG, HAOBO (PHARM D)
Entity Type:Individual
Prefix:
First Name:HAOBO
Middle Name:
Last Name:HUANG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3695 WINKLER AVENUE EXT
Mailing Address - Street 2:APT 733
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33916-9496
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3695 WINKLER AVENUE EXT
Practice Address - Street 2:APT 733
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33916-9496
Practice Address - Country:US
Practice Address - Phone:352-281-9776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-24
Last Update Date:2011-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist