Active NPI
Maryann Phan
- Pharmacist
- Winter Springs, FL
National Provider Identifier
1205791332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS69969
- Practice address
- 5650 Red Bug Lake Rd
Winter Springs, FL 32708-4904 - Phone
- (407) 699-0781
- NPI assigned
- Dec 20, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS69969 | FL | Primary |
Addresses
Primary practice location
5650 Red Bug Lake Rd
Winter Springs, FL 32708-4904
Mailing address
5650 Red Bug Lake Rd
Winter Springs, FL 32708-4904
Phone (407) 699-0781
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS69969 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1766188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1766188800000",
"number": "1205791332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5650 RED BUG LAKE RD",
"city": "WINTER SPRINGS",
"state": "FL",
"postal_code": "327084904",
"telephone_number": "407-699-0781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5650 RED BUG LAKE RD",
"city": "WINTER SPRINGS",
"state": "FL",
"postal_code": "327084904",
"telephone_number": "407-699-0781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "MARYANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-20",
"last_updated": "2025-12-20",
"certification_date": "2025-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS69969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winter Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.