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NPI Code Detail

MEDICARE: KIEU NGUYEN RPH

MEDICARE: KIEU NGUYEN RPH
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
1183500000XPharmacistPS57464FL

General Provider Information

NPI Number : 1316541386
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIEU NGUYEN RPH
Provider Business Mailing Address
First Line : 3050 N WICKHAM RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-2364
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3050 N WICKHAM RD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-2364
Country : US
Telephone Number : 321-751-7524
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2020
Last Update Date : 06/18/2021

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Directions to “ KIEU NGUYEN RPH” Practice Location

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