Provider Demographics
NPI:1457947426
Name:DUONG, RICHARD LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:DUONG
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 1:12528 DEERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-2336
Mailing Address - Country:US
Mailing Address - Phone:980-622-7124
Mailing Address - Fax:
Practice Address - Street 1:12528 DEERBERRY LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-2336
Practice Address - Country:US
Practice Address - Phone:980-622-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS56150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist