Provider Demographics
NPI:1598069056
Name:BAYDOUN, EMAD H (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:EMAD
Middle Name:H
Last Name:BAYDOUN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4749 34TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-4507
Mailing Address - Country:US
Mailing Address - Phone:727-329-8868
Mailing Address - Fax:727-329-8662
Practice Address - Street 1:4749 34TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-4507
Practice Address - Country:US
Practice Address - Phone:727-329-8868
Practice Address - Fax:727-329-8662
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist