Phuoc H Pham MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME29863 Issued in FL

Legal business name

PHUOC H PHAM MD

Practice address

819 N Pine Hills Rd
Orlando, FL 32808-7234

Phone

(407) 299-3166

Fax

(407) 299-3172

NPI assigned

May 20, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Xuan-Tieu Nguyen

Title

Office Manager

Phone

(407) 299-3166

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1013328434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N PINE HILLS RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087234",
            "telephone_number": "407-299-3166",
            "fax_number": "407-299-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N PINE HILLS RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087234",
            "telephone_number": "407-299-3166",
            "fax_number": "407-299-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHUOC H PHAM MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "XUAN-TIEU",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-299-3166",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME29863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058604800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phoenix Freedom Academy
• Alese Photiadis, PHARMD
• Thierry Phouthavong, PHARM.D.
• Mai Thi Truc Phung, MD
• Tran C. Phung, M.D.
• Physiatric Pain & Medical Rehabilitation Clinic PA
• Physical Feats, LLC
• Physical Medicine Group LLC
• Physical Therapy of Central Florida LLC
• Physical Therapy Specialists of Hunters Creek, LLC

• Family Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.