Provider Demographics
NPI:1619608742
Name:TRUONG, HANG (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HANG
Middle Name:
Last Name:TRUONG
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 1:4255 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2326
Mailing Address - Country:US
Mailing Address - Phone:646-853-9893
Mailing Address - Fax:
Practice Address - Street 1:4255 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2326
Practice Address - Country:US
Practice Address - Phone:352-597-7504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66966183500000X
MAPH277151835P0018X
FLPS63374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101486201Medicaid
FL101486200Medicaid
1051060OtherOTHER ID NUMBER-COMMERCIAL NUMBER