Healthcare Provider Details

I. General information

NPI: 1255063582
Provider Name (Legal Business Name): DANIEL AUGUSTUS BADOE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 NEMOURS PKWY GRADUATE MEDICAL EDUCATION
ORLANDO FL
32827
US

IV. Provider business mailing address

6535 NEMOURS PKWY GRADUATE MEDICAL EDUCATION
ORLANDO FL
32827
US

V. Phone/Fax

Practice location:
  • Phone: 407-650-7313
  • Fax:
Mailing address:
  • Phone: 407-650-7313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME181442
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: