Provider Demographics
NPI:1851886105
Name:BUI, HONG TU (PHAMD)
Entity Type:Individual
Prefix:
First Name:HONG TU
Middle Name:
Last Name:BUI
Suffix:
Gender:F
Credentials:PHAMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 13TH AVE N UNIT A
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-7327
Mailing Address - Country:US
Mailing Address - Phone:714-486-8314
Mailing Address - Fax:
Practice Address - Street 1:224 13TH AVE N UNIT A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-7327
Practice Address - Country:US
Practice Address - Phone:714-486-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist