Provider Demographics
NPI:1891263208
Name:NGUYEN, JULIE BACH (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BACH
Last Name:NGUYEN
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 1:11930 NARCOOSSEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6900
Mailing Address - Country:US
Mailing Address - Phone:407-204-2026
Mailing Address - Fax:
Practice Address - Street 1:11930 NARCOOSSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6900
Practice Address - Country:US
Practice Address - Phone:407-204-2026
Practice Address - Fax:407-204-2037
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS46409183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist