Healthcare Provider Details

I. General information

NPI: 1376377739
Provider Name (Legal Business Name): THIN THANT SIN KHINE PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13450 SUMMERPORT VILLAGE PKWY
WINDERMERE FL
34786-7366
US

IV. Provider business mailing address

8359 LAKE CROWELL CIRCLE
ORLANDO FL
32836
US

V. Phone/Fax

Practice location:
  • Phone: 407-905-0409
  • Fax:
Mailing address:
  • Phone: 407-757-9897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS67521
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: