MEDICARE: VIET NGUYEN

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	PS44087	FL

General Provider Information

NPI Number	:	1215568738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIET NGUYEN

Provider Business Mailing Address
First Line	:	125 SHORE CT APT 207A
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5550
Country	:	US
Telephone Number	:	305-215-6740
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 SHORE CT APT 207A
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5550
Country	:	US
Telephone Number	:	305-215-6740
Fax Number	:

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

Provider Enumeration Date	:	02/03/2020
Last Update Date	:	02/03/2020

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Directions to “ VIET NGUYEN ” Practice Location

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