Provider Demographics
NPI:1154690881
Name:NGUYEN, KHOI THANH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KHOI
Middle Name:THANH
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 W ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4210
Mailing Address - Country:US
Mailing Address - Phone:407-257-7004
Mailing Address - Fax:
Practice Address - Street 1:7003 PRESIDENTS DR STE 250
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-5533
Practice Address - Country:US
Practice Address - Phone:407-859-6197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist