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General NPI Number Information
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NPI Number | 1821565912
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Entity Type | Individual
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Provider Name | JACQUELINE ELIZABETH NGUYEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/27/2018
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Last Update Date | 10/27/2018
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Provider Practice Location Address
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Address Line | 3550 S BABCOCK ST
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City | MELBOURNE
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State | FL
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Zip | 32901-8204
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Country | US
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Telephone | 321-723-8830
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Fax |
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Provider Business Mailing Address
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Address Line | 8106 WHISTLEWING CT
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City | ORLANDO
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State | FL
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Zip | 32817-1559
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Country | US
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Telephone |
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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 | PS58355
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License Number State | FL
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