MEDICARE: THI TRAN

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	PS67659	FL

General Provider Information

NPI Number	:	1871320846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THI TRAN

Provider Business Mailing Address
First Line	:	1574 BRIAR OAK DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-6144
Country	:	US
Telephone Number	:	561-779-5908
Fax Number	:

Provider Business Practice Location Address
First Line	:	10155 OKEECHOBEE BLVD
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1404
Country	:	US
Telephone Number	:	561-784-2734
Fax Number	:

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

Provider Enumeration Date	:	09/16/2024
Last Update Date	:	09/16/2024

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