Provider Demographics
NPI:1881663672
Name:UDE, DONALD U (RPH)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:U
Last Name:UDE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10539 BRUUN PL
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-7214
Mailing Address - Country:US
Mailing Address - Phone:407-658-6050
Mailing Address - Fax:407-658-6169
Practice Address - Street 1:7333 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-6061
Practice Address - Country:US
Practice Address - Phone:407-658-6050
Practice Address - Fax:407-658-6169
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34577183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH21408OtherPHARMACY LICENSE