Provider Demographics
NPI:1508135039
Name:TRAN, MYHANH THI (PHARMD)
Entity Type:Individual
Prefix:
First Name:MYHANH
Middle Name:THI
Last Name:TRAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13130 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2406
Mailing Address - Country:US
Mailing Address - Phone:813-885-1539
Mailing Address - Fax:813-265-4406
Practice Address - Street 1:13130 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2406
Practice Address - Country:US
Practice Address - Phone:813-885-1539
Practice Address - Fax:813-265-4406
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36910183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist