Active NPI
Phuong Tuan Pham
- Pharmacist
- Orlando, FL
National Provider Identifier
1366085946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS49101
- Practice address
- 1926 Crosshair Cir
Orlando, FL 32837-7402 - Phone
- (407) 456-4170
- NPI assigned
- Oct 25, 2019
- Sex
- Male
- 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 | PS49101 | FL | Primary |
Addresses
Primary practice location
1926 Crosshair Cir
Orlando, FL 32837-7402
Mailing address
4444 W Vine St
Kissimmee, FL 34746-5315
Phone (407) 397-1002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS49101 | Other | FL | STATE LICENSE NUMBER |
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 |
|---|---|---|---|
| PS49101 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571961600000",
"number": "1366085946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4444 W VINE ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347465315",
"telephone_number": "407-397-1002",
"fax_number": "407-397-1249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1926 CROSSHAIR CIR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328377402",
"telephone_number": "407-456-4170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "PHUONG",
"middle_name": "TUAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-25",
"last_updated": "2019-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS49101",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "PS49101",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.