Provider Demographics
NPI:1518237098
Name:PHAM, AARON CHINH KIM (PHARMD)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:CHINH KIM
Last Name:PHAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 BRANTENBURG WAY
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-7932
Mailing Address - Country:US
Mailing Address - Phone:714-725-9689
Mailing Address - Fax:
Practice Address - Street 1:7925 GUNN HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1618
Practice Address - Country:US
Practice Address - Phone:813-920-9535
Practice Address - Fax:813-920-4943
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 39664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist