Individual
DR. PHALYKA OUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3700 NW 83RD ST, GAINESVILLE, FL 32606-5603
(352) 371-7546
(352) 335-7546
Mailing address
PO BOX 357730, GAINESVILLE, FL 32635-7730
(352) 371-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
115694
FL
208000000X
Pediatrics Physician
ME115694
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009664500
—
FL
Enumeration date
04/01/2010
Last updated
07/20/2021
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