MEDICARE: MR. MICHAEL HAI NGUYEN PHARMACIST

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	PS45038	FL

General Provider Information

NPI Number	:	1649586322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL HAI NGUYEN PHARMACIST

Provider Business Mailing Address
First Line	:	5706 BENJAMIN CENTER DR
Second Line	:	#103
City	:	TAMPA
State	:	FL
Zip	:	33634-5262
Country	:	US
Telephone Number	:	800-784-0882
Fax Number	:	813-514-0512

Provider Business Practice Location Address
First Line	:	5706 BENJAMIN CENTER DR
Second Line	:	#103
City	:	TAMPA
State	:	FL
Zip	:	33634-5262
Country	:	US
Telephone Number	:	800-784-0882
Fax Number	:	813-514-0512

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

Provider Enumeration Date	:	08/19/2010
Last Update Date	:	08/19/2010

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