MEDICARE: HIEP NGUYEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS65246	FL

General Provider Information

NPI Number	:	1083326938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIEP NGUYEN

Provider Business Mailing Address
First Line	:	11840 SOPHIA DR APT 4204
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-8413
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 W KENNEDY BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-1844
Country	:	US
Telephone Number	:	813-254-6309
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2022
Last Update Date	:	12/21/2022

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Directions to “ HIEP NGUYEN ” Practice Location

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