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General NPI Number Information
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NPI Number | 1689108748
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Entity Type | Individual
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Provider Name | LUAN DINH PHAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/16/2017
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 454 PARK AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33403-2602
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Country | US
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Telephone | 561-685-3530
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 WESLEY RD STE 110
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City | APOPKA
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State | FL
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Zip | 32712-5908
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Country | US
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Telephone | 866-943-4535
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Fax | 407-789-1479
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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 | PS55146
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License Number State | FL
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