Active NPI
Kevin Son Pham, PHARMD
- Pharmacist
- Clermont, FL
National Provider Identifier
1700489283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS53390
- Practice address
- 1800 E Hwy 50
Clermont, FL 34711-1914 - Phone
- (352) 243-7030
- NPI assigned
- Nov 18, 2020
- 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 | PS53390 | FL | Primary |
Addresses
Primary practice location
1800 E Hwy 50
Clermont, FL 34711-1914
Mailing address
17985 Gourd Neck Loop
Winter Garden, FL 34787-3090
Phone (714) 642-1891
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS53390 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1700489283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17985 GOURD NECK LOOP",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "347873090",
"telephone_number": "714-642-1891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 E HWY 50",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347111914",
"telephone_number": "352-243-7030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAM",
"first_name": "KEVIN",
"middle_name": "SON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-18",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS53390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.