Healthcare Provider Details

I. General information

NPI: 1245149863
Provider Name (Legal Business Name): RANDI SILCOX
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 N HIGHWAY 29
CANTONMENT FL
32533-5185
US

IV. Provider business mailing address

2435 N HIGHWAY 29
CANTONMENT FL
32533-5185
US

V. Phone/Fax

Practice location:
  • Phone: 850-516-8154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS66200
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: