Individual
DR. DOMINIQUE NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6308 BENJAMIN RD STE 709, TAMPA, FL 33634-5174
(727) 896-0001
(727) 896-0002
Mailing address
5210 FALLEN LEAF DR, RIVERVIEW, FL 33578-4740
(954) 328-4762
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PS54063
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS54063
DEPARTMENT OF HEALTH
FL
Enumeration date
04/06/2020
Last updated
09/01/2022
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