Individual provider Active NPI

Son Quoc Nguyen, PHARMACIST

  • Ambulatory Care Pharmacist
  • Sun City Center, FL
National Provider Identifier
1083295950
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Care PharmacistTaxonomy code 1835P2201X
License
PS55752 Issued in FL
Practice address
765 Cortaro Dr
Sun City Center, FL 33573-6812
Phone
(813) 551-2999
Fax
(813) 922-4155
NPI assigned
Apr 21, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Pharmacist 1835P2201X PS55752 FL Primary

Addresses

Primary practice location

765 Cortaro Dr
Sun City Center, FL 33573-6812

Mailing address

765 Cortaro Dr
Sun City Center, FL 33573-6812
Phone (813) 551-2999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PS55752FLMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Superior Care Pharmacy LLC CurrentSince Jul 24, 2022 Accepting new patients

Locations

765 Cortaro Dr
Sun City Center, FL 33573
Phone (813) 551-2999

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1083295950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 CORTARO DR",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736812",
            "telephone_number": "813-551-2999",
            "fax_number": "813-922-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 CORTARO DR",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736812",
            "telephone_number": "813-551-2999",
            "fax_number": "813-922-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "SON",
        "middle_name": "QUOC",
        "credential": "PHARMACIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "FL",
            "license": "PS55752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.