Provider Demographics
NPI:1962771758
Name:NGUYEN, TRANG MAI THI (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:TRANG
Middle Name:MAI THI
Last Name:NGUYEN
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 1:6440 ORCHARD ORIOLE LN
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-8284
Mailing Address - Country:US
Mailing Address - Phone:941-920-1127
Mailing Address - Fax:941-954-1726
Practice Address - Street 1:6440 ORCHARD ORIOLE LN
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202
Practice Address - Country:US
Practice Address - Phone:941-920-1127
Practice Address - Fax:941-954-1726
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist