Active NPI
Phu Nguyen, PHARM.D
- Community/Retail Pharmacy
- Miami, FL
National Provider Identifier
1366091050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PS59809
- Practice address
- 1400 NW 12TH Ave Ste 2002
Miami, FL 33136-1003 - Phone
- (305) 702-9065
- NPI assigned
- Sep 5, 2019
- Last updated
- Dec 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PS59809 | FL | Primary |
Addresses
Primary practice location
1400 NW 12TH Ave Ste 2002
Miami, FL 33136-1003
Mailing address
1400 NW 12TH Ave Ste 2002
Miami, FL 33136-1003
Phone (786) 512-0679
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS59809 | FL | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Community/Retail Pharmacy | Current | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past | Accepting new patients |
Locations
1400 NW 12th Ave
Ste 2002
Miami, FL 33136
Phone (305) 702-9065
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672012800000",
"number": "1366091050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 NW 12TH AVE STE 2002",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361003",
"telephone_number": "786-512-0679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 NW 12TH AVE STE 2002",
"city": "MIAMI",
"state": "FL",
"postal_code": "331361003",
"telephone_number": "305-702-9065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "PHU",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-05",
"last_updated": "2022-12-26",
"certification_date": "2022-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "FL",
"license": "PS59809",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.