Healthcare Provider Details

I. General information

NPI: 1538070677
Provider Name (Legal Business Name): ALLYSON BAO-HAN PHAM PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1549 GALE LEMERAND DR STE 1540
GAINESVILLE FL
32610-3008
US

IV. Provider business mailing address

7693 SW 57TH LN APT 13-159
GAINESVILLE FL
32608-4593
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-8272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number71568
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: