Provider Demographics
NPI:1689986028
Name:BABOO, REKI (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:REKI
Middle Name:
Last Name:BABOO
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 SW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4964
Mailing Address - Country:US
Mailing Address - Phone:954-584-0731
Mailing Address - Fax:
Practice Address - Street 1:7421 SW 16TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-4964
Practice Address - Country:US
Practice Address - Phone:954-584-0731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054535183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist