Provider Demographics
NPI:1245869684
Name:BUI, HUONG NGUYEN (PHARMD)
Entity type:Individual
Prefix:
First Name:HUONG
Middle Name:NGUYEN
Last Name:BUI
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 1:2657 LAKEBREEZE LN N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1081
Mailing Address - Country:US
Mailing Address - Phone:727-505-6844
Mailing Address - Fax:
Practice Address - Street 1:1000 E TARPON AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-5438
Practice Address - Country:US
Practice Address - Phone:727-937-4203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051299939183500000X
FLPS58068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS58068OtherSTATE LICENSE
FLPS58068OtherLICENSE