Individual
DR. PHONG MICHAEL PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1571 PERIWINKLE WAY, SANIBEL, FL 33957-4513
(239) 472-4204
(239) 415-7341
Mailing address
6747 WILLOW LAKE CIR, FORT MYERS, FL 33966-1253
(239) 472-4204
(239) 415-7341
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPC3502
FL
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC3502
FL
Other
Enumeration date
02/23/2007
Last updated
06/08/2022
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