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General NPI Number Information
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NPI Number | 1003794587
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Entity Type | Individual
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Provider Name | DANH CONG PHAM RPH
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Gender | Male
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Dates
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Enumeration Date | 08/23/2025
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Last Update Date | 08/23/2025
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Provider Practice Location Address
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Address Line | 3501 54TH AVE S
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City | SAINT PETERSBURG
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State | FL
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Zip | 33711-4541
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Country | US
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Telephone | 727-864-1546
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Fax |
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Provider Business Mailing Address
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Address Line | 4055 76TH AVE N APT 4
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3615
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Country | US
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Telephone | 727-481-1284
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS69335
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License Number State | FL
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