Healthcare Provider Details

I. General information

NPI: 1942120928
Provider Name (Legal Business Name): MATTHEW TRIEU NGUYEN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 MCMULLEN BOOTH RD
SAFETY HARBOR FL
34695-6607
US

IV. Provider business mailing address

1738 BROAD WINGED HAWK DR
RUSKIN FL
33570-4956
US

V. Phone/Fax

Practice location:
  • Phone: 727-725-6111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS70788
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: