Healthcare Provider Details

I. General information

NPI: 1790444966
Provider Name (Legal Business Name): FORIN HUANG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2021
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 S FLORIDA AVE
LAKELAND FL
33813-2181
US

IV. Provider business mailing address

237 ST GEORGES CIR
EAGLE LAKE FL
33839-5211
US

V. Phone/Fax

Practice location:
  • Phone: 863-646-5471
  • Fax:
Mailing address:
  • Phone: 863-670-6127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number63622
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: