Provider Demographics
NPI:1174978902
Name:VU, PETER Q (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:Q
Last Name:VU
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14728 GAINESBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4001
Mailing Address - Country:US
Mailing Address - Phone:407-380-9724
Mailing Address - Fax:407-380-9637
Practice Address - Street 1:201 S CHICKASAW TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3504
Practice Address - Country:US
Practice Address - Phone:407-380-9724
Practice Address - Fax:407-380-9637
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS40302OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH