Provider Demographics
NPI:1982468849
Name:PAWLICKI, NICOLE BARBARA (PHARMD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:BARBARA
Last Name:PAWLICKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 SAGECREST CIR APT 104
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8673
Mailing Address - Country:US
Mailing Address - Phone:847-848-4017
Mailing Address - Fax:
Practice Address - Street 1:3680 N WICKHAM RD STE C
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2327
Practice Address - Country:US
Practice Address - Phone:321-608-4949
Practice Address - Fax:321-477-5407
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS66646183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist