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NPI Code Detail

MEDICARE: DR. QUAN MINH PHO PHARM D

MEDICARE: DR. QUAN MINH PHO PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPS36843FL

General Provider Information

NPI Number : 1093718181
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. QUAN MINH PHO PHARM D
Provider Business Mailing Address
First Line : 4467 SW LA PALOMA DR
Second Line :
City : PALM CITY
State : FL
Zip : 34990-7949
Country : US
Telephone Number : 772-708-9722
Fax Number :
Provider Business Practice Location Address
First Line : 1796 HIGHWAY 441 N
Second Line :
City : OKEECHOBEE
State : FL
Zip : 34972-1918
Country : US
Telephone Number : 863-824-2893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/08/2007

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Directions to “ DR. QUAN MINH PHO PHARM D” Practice Location

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