Individual
DR. DAT CAO PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 PALM AVE STE 600, JACKSONVILLE, FL 32207-8432
(904) 202-7300
(904) 202-2754
Mailing address
PO BOX 746654, ATLANTA, GA 30374-6654
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME76623
FL
207RX0202X
Medical Oncology Physician
Primary
ME76623
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000948868A
—
GA
05
—
2642018-00
—
FL
Enumeration date
03/29/2006
Last updated
05/06/2025
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