Tina Hieu Nguyen
Individual provider Active NPI Pharmacist · Flagler Beach, FL
NPI 1003699422 · NPPES record last updated Aug 17, 2023
Key facts
- NPI
- 1003699422
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PS66177 (FL)
- Practice address
- 2301 Moody Blvd
Flagler Beach, FL 32136-4427 - Phone
- (386) 439-0271
- NPI assigned
- Aug 17, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS66177 | FL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS66177 | FL | Yes |
Addresses
Primary practice location
2301 Moody Blvd
Flagler Beach, FL 32136-4427
Mailing address
480 Lambert Ave
Flagler Beach, FL 32136-3215
Phone (386) 793-2460
Other providers in Flagler Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.