Provider Demographics
NPI:1780805267
Name:MACH, HOANG P (RPH)
Entity type:Individual
Prefix:
First Name:HOANG
Middle Name:P
Last Name:MACH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S HIAWASSEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5715
Mailing Address - Country:US
Mailing Address - Phone:407-295-2333
Mailing Address - Fax:407-578-7100
Practice Address - Street 1:1401 S HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5715
Practice Address - Country:US
Practice Address - Phone:407-295-2333
Practice Address - Fax:407-578-7100
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30696183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106088100Medicaid
FL108067OtherNABP
FL1528089836OtherSTORE NPI
FLPS30696OtherPHARMACY LICENSE NO.
FLPS30696OtherPHARMACY LICENSE NO.