Healthcare Provider Details

I. General information

NPI: 1235610171
Provider Name (Legal Business Name): JAME QUOC TRAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES QUOC TRAN PHARMD

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 CORPOREX PARK DR STE 115
TAMPA FL
33619-1179
US

IV. Provider business mailing address

19390 CORTEZ BLVD
BROOKSVILLE FL
34601-3041
US

V. Phone/Fax

Practice location:
  • Phone: 888-319-1818
  • Fax:
Mailing address:
  • Phone: 352-796-2928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS58133
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: