Provider Demographics
NPI:1598185746
Name:BADIKI, PAULINE MEDIKO (PHARMACIST)
Entity Type:Individual
Prefix:MISS
First Name:PAULINE
Middle Name:MEDIKO
Last Name:BADIKI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:MS
Other - First Name:PAULINE
Other - Middle Name:MEDIKO
Other - Last Name:BADIKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:1900 JAKE ST
Mailing Address - Street 2:UNIT 220
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32814-5915
Mailing Address - Country:US
Mailing Address - Phone:404-543-9163
Mailing Address - Fax:
Practice Address - Street 1:1900 JAKE ST
Practice Address - Street 2:UNITS
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-5915
Practice Address - Country:US
Practice Address - Phone:404-543-9163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30324171W00000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No183500000XPharmacy Service ProvidersPharmacist