MEDICARE: VIVIAN TU

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	PS69391	FL

General Provider Information

NPI Number	:	1689552291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN TU

Provider Business Mailing Address
First Line	:	PO BOX 407
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33802-0407
Country	:	US
Telephone Number	:	863-688-1188
Fax Number	:

Provider Business Practice Location Address
First Line	:	5140 COUNTY LINE RD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33811-2048
Country	:	US
Telephone Number	:	863-644-1376
Fax Number	:

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

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	08/22/2025

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Directions to “ VIVIAN TU ” Practice Location

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