Provider Demographics
NPI:1205438819
Name:NGUYEN, TIEN TOMMY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TIEN
Middle Name:TOMMY
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3429 HICKORY HAMMOCK LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7303
Mailing Address - Country:US
Mailing Address - Phone:813-579-0040
Mailing Address - Fax:
Practice Address - Street 1:1575 LAND O LAKES BLVD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-2930
Practice Address - Country:US
Practice Address - Phone:813-949-3664
Practice Address - Fax:813-949-4642
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40659183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist