MEDICARE: NANCY TRAN PHARMA D

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	PS57402	FL

General Provider Information

NPI Number	:	1275289928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY TRAN PHARMA D

Provider Business Mailing Address
First Line	:	7599 PARK BLVD N STE 100
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-2904
Country	:	US
Telephone Number	:	727-914-5227
Fax Number	:

Provider Business Practice Location Address
First Line	:	7599 PARK BLVD N STE 100
Second Line	:
City	:	PINELLAS PARK
State	:	FL
Zip	:	33781-2904
Country	:	US
Telephone Number	:	727-914-5227
Fax Number	:

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

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	02/22/2022

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