Healthcare Provider Details

I. General information

NPI: 1437774130
Provider Name (Legal Business Name): MIN MEI KUO PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 06/09/2020
Certification Date: 06/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N UNIVERSITY DR
TAMARAC FL
33321-2920
US

IV. Provider business mailing address

4952 ROTHSCHILD DR
CORAL SPRINGS FL
33067-4134
US

V. Phone/Fax

Practice location:
  • Phone: 954-724-1807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS50418
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: