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General NPI Number Information
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NPI Number | 1992518708
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Entity Type | Individual
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Provider Name | VIJAYA KODE
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 3390 N HIGHWAY 67
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City | FLORISSANT
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State | MO
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Zip | 63033-1605
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Country | US
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Telephone | 314-824-0022
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Fax |
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Provider Business Mailing Address
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Address Line | 10432 MIDDLEWICH DR
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City | ORLANDO
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State | FL
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Zip | 32832-6918
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Country | US
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Telephone | 954-562-2447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS44330
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2025000954
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License Number State | MO
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