Provider Demographics
NPI:1134005796
Name:FLORIDA DEPT OF CORRECTIONS
Entity type:Organization
Organization Name:FLORIDA DEPT OF CORRECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUREAU CHIEF OF PHARMACEUTICAL SERV
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:850-717-3287
Mailing Address - Street 1:501 S. CALHOUN STREET FLORIDA DEPT OF CORRECTIONS
Mailing Address - Street 2:ATTN: PHARMACY SERVICES
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32399
Mailing Address - Country:US
Mailing Address - Phone:850-717-3287
Mailing Address - Fax:
Practice Address - Street 1:7765 S. CR 231 RECEPTION AND MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:LAKE BUTLER
Practice Address - State:FL
Practice Address - Zip Code:32054
Practice Address - Country:US
Practice Address - Phone:386-496-7241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA DEPT OF CORRECTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy