MEDICARE: HAI QUANG DOAN PHARM.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	PS55680	FL

General Provider Information

NPI Number	:	1700421815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAI QUANG DOAN PHARM.D

Provider Business Mailing Address
First Line	:	3306 N UNIVERSITY DR
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-6773
Country	:	US
Telephone Number	:	954-749-5781
Fax Number	:	954-749-6686

Provider Business Practice Location Address
First Line	:	3306 N UNIVERSITY DR
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-6773
Country	:	US
Telephone Number	:	954-749-5781
Fax Number	:	954-749-6686

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

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	11/13/2020

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