Provider Demographics
NPI:1821420183
Name:TRUONG, SANDY THI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:THI
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 1:16417 SW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4464
Mailing Address - Country:US
Mailing Address - Phone:561-309-4654
Mailing Address - Fax:
Practice Address - Street 1:401 E SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-4603
Practice Address - Country:US
Practice Address - Phone:954-988-5210
Practice Address - Fax:954-988-5208
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS50847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist