MEDICARE: TUYET MINH NGOC LE PHARMD

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	56420	FL

General Provider Information

NPI Number	:	1720500192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TUYET MINH NGOC LE PHARMD

Provider Business Mailing Address
First Line	:	5007 E 110TH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-2158
Country	:	US
Telephone Number	:	954-918-1556
Fax Number	:

Provider Business Practice Location Address
First Line	:	5007 EAST 110TH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617
Country	:	US
Telephone Number	:	954-918-1556
Fax Number	:

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

Provider Enumeration Date	:	07/07/2017
Last Update Date	:	07/21/2022

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