Provider Demographics
NPI:1376655993
Name:DAUDU, MOPELOLA (RPH)
Entity Type:Individual
Prefix:
First Name:MOPELOLA
Middle Name:
Last Name:DAUDU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9535 E FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:THONOTOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:33592-2139
Mailing Address - Country:US
Mailing Address - Phone:813-986-0788
Mailing Address - Fax:813-986-9607
Practice Address - Street 1:9535 E FOWLER AVE
Practice Address - Street 2:
Practice Address - City:THONOTOSASSA
Practice Address - State:FL
Practice Address - Zip Code:33592-2139
Practice Address - Country:US
Practice Address - Phone:813-986-0788
Practice Address - Fax:813-986-9607
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0029336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist