Provider Demographics
NPI:1255602991
Name:VO, THAO PHUONG (RPH)
Entity type:Individual
Prefix:
First Name:THAO
Middle Name:PHUONG
Last Name:VO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5019
Mailing Address - Country:US
Mailing Address - Phone:407-894-6781
Mailing Address - Fax:407-894-9457
Practice Address - Street 1:1420 39TH ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-8920
Practice Address - Country:US
Practice Address - Phone:407-894-6781
Practice Address - Fax:407-894-9457
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist