Individual
ALYSSA PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
8851 BOARDROOM CIR, FORT MYERS, FL 33919-4888
(239) 237-0962
Mailing address
8851 BOARDROOM CIR, FORT MYERS, FL 33919-4888
(239) 237-0962
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO4262
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/30/2018
Last updated
06/21/2023
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