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General NPI Number Information
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NPI Number | 1336025998
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Entity Type | Organization
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Legal Business Name | FLORIDA DEPT OF CORRECTIONS
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 25636 NE SR 16 (FLORIDA DEPT. OF CORRECTIONS - REGION I
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City | RAIFORD
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State | FL
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Zip | 32083
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Country | US
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Telephone | 386-431-4096
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Fax | 386-431-2190
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Provider Business Mailing Address
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Address Line | 601 S. CALHOUN STREET, FLORIDA DEPT. OF CORRECTIONS ATTN: PHARMACY SERVICES
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City | TALLAHASSEE
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State | FL
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Zip | 32399
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Country | US
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Telephone | 850-717-3287
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Fax |
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Authorized Official
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Title or Position | BUREAU CHIEF OF PHARMACEUTICAL SERV
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Name | DR. RENEA MARCANO
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Credential | PHARMD
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Telephone | 850-717-3287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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