MEDICARE: HOANG CUC THI NGUYEN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS39043	FL

General Provider Information

NPI Number	:	1003185398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOANG CUC THI NGUYEN PHARMD

Provider Business Mailing Address
First Line	:	8242 LYNCH DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-5900
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4502 S ORANGE BLOSSOM TRL
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-1704
Country	:	US
Telephone Number	:	407-851-6040
Fax Number	:	407-859-2558

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2011
Last Update Date	:	12/15/2011

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Directions to “ HOANG CUC THI NGUYEN PHARMD” Practice Location

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