Provider Demographics
NPI:1649271982
Name:DUONG, MINH-TRI L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MINH-TRI
Middle Name:L
Last Name:DUONG
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 1:2925 W KNIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-1621
Mailing Address - Country:US
Mailing Address - Phone:813-844-4735
Mailing Address - Fax:813-844-4062
Practice Address - Street 1:2 COLUMBIA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3508
Practice Address - Country:US
Practice Address - Phone:813-844-4473
Practice Address - Fax:813-844-4062
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS-325771835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS-32577OtherPHARMACY LICENSE NUMBER