Healthcare Provider Details

I. General information

NPI: 1578655585
Provider Name (Legal Business Name): QUETRAN DUY HOANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 W NEWBERRY RD
GAINESVILLE FL
32605-4309
US

IV. Provider business mailing address

5137 SW 82ND TER
GAINESVILLE FL
32608-7407
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-4170
  • Fax:
Mailing address:
  • Phone: 352-373-4858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS36662
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: