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NPI Code Detail

MEDICARE: TIM NGUYEN

MEDICARE: TIM 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
1333600000XPharmacyPSI47116FL

General Provider Information

NPI Number : 1518890102
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIM NGUYEN
Provider Business Mailing Address
First Line : 1645 RENAISSANCE COMMONS BLVD APT 1417
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-8352
Country : US
Telephone Number : 561-523-9450
Fax Number :
Provider Business Practice Location Address
First Line : 12425 HAGEN RANCH RD
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33437-4107
Country : US
Telephone Number : 561-292-4494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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