Provider Demographics
NPI:1578251641
Name:ON, LOC VINH (RPH)
Entity Type:Individual
Prefix:
First Name:LOC VINH
Middle Name:
Last Name:ON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 NE 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-5328
Mailing Address - Country:US
Mailing Address - Phone:407-683-0624
Mailing Address - Fax:
Practice Address - Street 1:17817 SE 109TH AVE
Practice Address - Street 2:
Practice Address - City:SUMMERFIELD
Practice Address - State:FL
Practice Address - Zip Code:34491-8999
Practice Address - Country:US
Practice Address - Phone:407-683-0624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist