Provider Demographics
NPI:1285253427
Name:LE, VAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VAN
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6971 N FEDERAL HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1648
Mailing Address - Country:US
Mailing Address - Phone:888-536-9963
Mailing Address - Fax:
Practice Address - Street 1:6971 N FEDERAL HWY STE 203
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1648
Practice Address - Country:US
Practice Address - Phone:888-536-9963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58793183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist