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NPI Code Detail

MEDICARE: RONALD PHAM DO

MEDICARE: RONALD PHAM DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianOS16252FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629509591
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD PHAM DO
Provider Business Mailing Address
First Line : 1100 E BROWARD BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-2012
Country : US
Telephone Number : 954-463-5271
Fax Number : 954-463-1087
Provider Business Practice Location Address
First Line : 1100 E BROWARD BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-2012
Country : US
Telephone Number : 954-463-5271
Fax Number : 954-463-1087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2017
Last Update Date : 01/30/2023

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Directions to “ RONALD PHAM DO” Practice Location

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