Individual provider Active NPI

Ngon-Vincent Van, PHARM.D.

  • Pharmacist
  • Doral, FL
National Provider Identifier
1649921412
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS58844 Issued in FL
Practice address
10913 NW 30TH St Ste 102
Doral, FL 33172-5029
Phone
(888) 648-1134
NPI assigned
Jan 13, 2022
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS58844 FL Primary

Addresses

Primary practice location

10913 NW 30TH St Ste 102
Doral, FL 33172-5029

Mailing address

1901 NE 15TH Ave
Fort Lauderdale, FL 33305-3260
Phone (870) 656-2420

Other practice location 1

3700 NW 126th Ave
Coral Springs, FL 33065-2408
Phone (754) 529-8353

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

LicenseStateTypeSpecialty
PS58844FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Parlay Pharma Corp Current Accepting new patients
Hephaestus Pharmaceuticals LLC CurrentSince Apr 13, 2025 Accepting new patients
Cre8 Pharmacy Group PastSince Jan 1, 2022 Accepting new patients

Locations

10913 NW 30th St
Ste 102
Doral, FL 33172
Phone (888) 648-1134

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1649921412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 NE 15TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333053260",
            "telephone_number": "870-656-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10913 NW 30TH ST STE 102",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331725029",
            "telephone_number": "888-648-1134"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 NW 126th Ave",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330652408",
            "country_code": "US",
            "telephone_number": "754-529-8353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN",
        "first_name": "NGON-VINCENT",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-13",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS58844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.