Provider Demographics
NPI:1376136002
Name:LE, HOANG MINH (PHD)
Entity Type:Individual
Prefix:
First Name:HOANG
Middle Name:MINH
Last Name:LE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5886 CONROY RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-3528
Mailing Address - Country:US
Mailing Address - Phone:407-299-8020
Mailing Address - Fax:
Practice Address - Street 1:5886 CONROY RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3528
Practice Address - Country:US
Practice Address - Phone:407-299-8020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist