Provider Demographics
NPI:1336429919
Name:TRUONG, AIHA TRAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:AIHA
Middle Name:TRAN
Last Name:TRUONG
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 1:2527 NORTHAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7906
Mailing Address - Country:US
Mailing Address - Phone:407-736-1299
Mailing Address - Fax:407-568-8176
Practice Address - Street 1:16900 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32820-1911
Practice Address - Country:US
Practice Address - Phone:407-568-4199
Practice Address - Fax:407-568-8176
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS037241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist