Provider Demographics
NPI:1336417856
Name:NGUYEN, MICHELLE T (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:T
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 LITTLE WEKIVA RD
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-7306
Mailing Address - Country:US
Mailing Address - Phone:407-577-7182
Mailing Address - Fax:407-203-4784
Practice Address - Street 1:448 S ALAFAYA TRL STE 2
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8998
Practice Address - Country:US
Practice Address - Phone:407-203-3805
Practice Address - Fax:407-203-4784
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042290Y183500000X
FLPS48868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist