Provider Demographics
NPI:1447640198
Name:KODE, DURGA SAROJANI (PHARMD)
Entity type:Individual
Prefix:
First Name:DURGA SAROJANI
Middle Name:
Last Name:KODE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DURGA
Other - Middle Name:SAROJANI
Other - Last Name:KODE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:13726 BUDWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6114
Mailing Address - Country:US
Mailing Address - Phone:850-264-7170
Mailing Address - Fax:
Practice Address - Street 1:13726 BUDWORTH CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6114
Practice Address - Country:US
Practice Address - Phone:850-264-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41947183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist