Individual provider Active NPI

Phuong K Ong, PHARM D

  • Pharmacist
  • Lake Buena Vista, FL
National Provider Identifier
1649765710
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS36142 Issued in FL
Practice address
960 Back Stage LN
Lake Buena Vista, FL 32830-8472
Phone
(407) 934-2030
Fax
(407) 934-2031
NPI assigned
Jun 29, 2018
Last updated
Jun 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS36142 FL Primary

Addresses

Primary practice location

960 Back Stage LN
Lake Buena Vista, FL 32830-8472

Mailing address

960 Back Stage LN
Lake Buena Vista, FL 32830-8472
Phone (407) 934-2030

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS36142FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1649765710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 BACK STAGE LN",
            "city": "LAKE BUENA VISTA",
            "state": "FL",
            "postal_code": "328308472",
            "telephone_number": "407-934-2030",
            "fax_number": "407-934-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 BACK STAGE LN",
            "city": "LAKE BUENA VISTA",
            "state": "FL",
            "postal_code": "328308472",
            "telephone_number": "407-934-2030",
            "fax_number": "407-934-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONG",
        "first_name": "PHUONG",
        "middle_name": "K",
        "credential": "PHARM D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS36142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Buena Vista, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.