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General NPI Number Information
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NPI Number | 1801279898
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Entity Type | Individual
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Provider Name | PETER HUY-VIET PHAM O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2015
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 3144 N MIAMI AVE
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City | MIAMI
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State | FL
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Zip | 33127-3718
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Country | US
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Telephone | 305-537-5731
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 BAY RD APT 647
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City | MIAMI BEACH
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State | FL
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Zip | 33139-3238
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Country | US
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Telephone |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC5132
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901004912
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License Number State | MI
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