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NPI Code Detail

MEDICARE: NA KIEU NGUYEN PHARM D

MEDICARE:   NA KIEU NGUYEN  PHARM D
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
1183500000XPharmacistPS43825FL

General Provider Information

NPI Number : 1790022564
Entity Type Code : Individual
Provider Name (Legal Business Name) : NA KIEU NGUYEN PHARM D
Provider Business Mailing Address
First Line : 12425 HAGEN RANCH RD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-4107
Country : US
Telephone Number : 561-292-4494
Fax Number : 561-292-4499
Provider Business Practice Location Address
First Line : 12425 HAGEN RANCH RD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-4107
Country : US
Telephone Number : 561-292-4494
Fax Number : 561-292-4499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2013
Last Update Date : 01/13/2013

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