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General NPI Number Information
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NPI Number | 1144858671
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Entity Type | Individual
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Provider Name | PHAP VAN TRUONG PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 03/30/2020
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Provider Practice Location Address
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Address Line | 2780 NE 8TH ST
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City | HOMESTEAD
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State | FL
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Zip | 33033-5699
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Country | US
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Telephone | 305-245-4992
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Fax | 303-245-4975
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Provider Business Mailing Address
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Address Line | 2814 WINDCREST OAKS CT
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City | VALRICO
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State | FL
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Zip | 33594-3903
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Country | US
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Telephone | 813-943-3366
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS58394
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License Number State | FL
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