Individual provider Active NPI

Duong T Nguyen

  • Pharmacist
  • Mary Esther, FL
National Provider Identifier
1558964460
Registry record updated Nov 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS60619 Issued in FL
Practice address
250 E Miracle Strip Pkwy
Mary Esther, FL 32569-1924
Phone
(850) 243-9557
Fax
(850) 659-3287
NPI assigned
Nov 21, 2020
Last updated
Nov 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS60619 FL Primary

Addresses

Primary practice location

250 E Miracle Strip Pkwy
Mary Esther, FL 32569-1924

Mailing address

534 Parish Blvd
Mary Esther, FL 32569-3427
Phone (912) 224-7445

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
PS60619FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1558964460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 PARISH BLVD",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325693427",
            "telephone_number": "912-224-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E MIRACLE STRIP PKWY",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691924",
            "telephone_number": "850-243-9557",
            "fax_number": "850-659-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "DUONG",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-21",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mary Esther, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; 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.