Eric Phan, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PS63015 Issued in FL

Practice address

6031 Cypress Gardens Blvd
Winter Haven, FL 33884-4115

Phone

(863) 324-1557

NPI assigned

Jun 29, 2022

Last updated

Jun 29, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Publix Super Markets Inc

  dba Publix Pharmacy #2107

  • Community/Retail Pharmacy
  • Winter Haven, FL
  • NPI 1760356380
  NPD (past)

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1770215584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4269 129TH AVE N",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334118950",
            "telephone_number": "561-281-3532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6031 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338844115",
            "telephone_number": "863-324-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS63015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "PS63015",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Stutz Perry, APRN
• Personal Assistant Transport Services, LLC
• Patricia Renee Pessar, PA-C
• Romana Petrovich, ARNP
• Khoa Pham, PHARM. D.
• Marlynn Patray Pharnes, LMHC
• Neetha Rachel Philip
• Phillips Salomon & Parrish PA
• James A Phillips, OD
• Stephen F Phillips, OD

• Pharmacist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.