Organization
JOHN-PAUL PHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN-PAUL PHAM MD (OWNER)
(904) 513-3179
Entity
Organization
Contact information
Practice address
8075 GATE PKWY W STE 302, JACKSONVILLE, FL 32216-3685
(904) 513-3179
(904) 337-1641
Mailing address
8075 GATE PKWY W STE 302, JACKSONVILLE, FL 32216-3685
(904) 513-3179
(904) 337-1641
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
ME107417
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016132100
—
FL
05
—
024325001
—
FL
01
—
ONK5E
FLORIDA BLUE
FL
Enumeration date
03/14/2018
Last updated
09/22/2025
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