Healthcare Provider Details

I. General information

NPI: 1245011071
Provider Name (Legal Business Name): AARON QUOC LAM PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 MEDICAL CENTER DR
ORANGE CITY FL
32763-8200
US

IV. Provider business mailing address

1061 MEDICAL CENTER DR STE 112
ORANGE CITY FL
32763-8225
US

V. Phone/Fax

Practice location:
  • Phone: 386-917-7801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS66473
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: