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General NPI Number Information
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NPI Number | 1295321685
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Entity Type | Individual
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Provider Name | NAM QUOC NGUYEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/19/2020
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Last Update Date | 12/19/2020
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Provider Practice Location Address
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Address Line | 7195 STATE ROAD 70 E
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City | BRADENTON
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State | FL
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Zip | 34203-9769
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Country | US
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Telephone | 941-727-2803
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Fax |
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Provider Business Mailing Address
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Address Line | 5717 AUTUMN FERN CIR
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City | SARASOTA
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State | FL
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Zip | 34238-5187
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Country | US
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Telephone | 352-284-3196
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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 | PS56337
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License Number State | FL
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