Provider Demographics
NPI:1447914130
Name:TUAZON, KATRINA (PHARMD)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:TUAZON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 HENDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2041
Mailing Address - Country:US
Mailing Address - Phone:786-246-2418
Mailing Address - Fax:
Practice Address - Street 1:2619 HENDERSON AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2041
Practice Address - Country:US
Practice Address - Phone:786-246-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3162731835P1200X
DCPH100002245183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCPH100002245OtherPHARMACIST LICENSE