Provider Demographics
NPI:1760363477
Name:RENDON BARBA, COYITA DE LOS ANGELES
Entity type:Individual
Prefix:
First Name:COYITA
Middle Name:DE LOS ANGELES
Last Name:RENDON BARBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 TERRALYN LN
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4936
Mailing Address - Country:US
Mailing Address - Phone:727-364-7818
Mailing Address - Fax:
Practice Address - Street 1:11001 DANKA WAY N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-3723
Practice Address - Country:US
Practice Address - Phone:800-947-3131
Practice Address - Fax:800-952-4488
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS31144183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist