MEDICARE: PUBLIX SUPER MARKETS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH0017925	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2013991	OTHER	PK

General Provider Information

NPI Number	:	1619916582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PUBLIX SUPER MARKETS INC

Provider Business Mailing Address
First Line	:	PO BOX 639680
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-9680
Country	:	US
Telephone Number	:	863-688-1188
Fax Number	:	863-616-5846

Provider Business Practice Location Address
First Line	:	3450 BAYSIDE LAKES BLVD SE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32909-6815
Country	:	US
Telephone Number	:	321-725-3757
Fax Number	:	321-725-5881

Authorized Official
Title or Position	:	VP OF PHARMACY
Name	:	CATHERINE E SCANLON
Credential	:
Telephone Number	:	863-688-1188

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/23/2026

Similar Medicare Providers

1275871816 — DR. EDWARD C STOCKER PHARMD.
Practice Location Address:

3450 BAYSIDE LAKES BLVD SE
PALM BAY, FL
32909-6815

Practice Phone: 321-725-3757
Practice Fax: 321-725-5881

1821974197 — KARLA DENISSE HERNANDEZ MARTINEZ PHARMD
Practice Location Address:

3450 BAYSIDE LAKES BLVD SE
PALM BAY, FL
32909-6815

Practice Phone: 321-725-2420
Practice Fax:

1558214759 — KAREN MENDOZA FNP-C
Practice Location Address:

213 DESERT PALM DR
LAREDO, TX
78045-6815

Practice Phone: 956-744-6143
Practice Fax:

1689117715 — NORMA BATISTA ARNP
Practice Location Address:

18469 S DIXIE HWY
CUTLER BAY, FL
33157-6815

Practice Phone: 786-949-6715
Practice Fax: 786-706-7844

1750551941 — ALBERTO M. JACIR-MARCANO MD, MBA
Practice Location Address:

18469 S DIXIE HWY
CUTLER BAY, FL
33157-6815

Practice Phone: 855-226-6633
Practice Fax: 866-285-7068

1821594128 — DR. ANGEL G BATISTA ITURRIAGA MD
Practice Location Address:

18469 S DIXIE HWY
CUTLER BAY, FL
33157-6815

Practice Phone: 786-949-6715
Practice Fax: 866-554-1760

Directions to “PUBLIX SUPER MARKETS INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.