Provider Demographics
NPI:1497527063
Name:TRAN, ALEXIS MY-HUYEN
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MY-HUYEN
Last Name:TRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5017 TULIP DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-4167
Mailing Address - Country:US
Mailing Address - Phone:850-291-7172
Mailing Address - Fax:
Practice Address - Street 1:811 N FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-4360
Practice Address - Country:US
Practice Address - Phone:850-453-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS66465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist