Provider Demographics
NPI:1861371015
Name:DRAKE, CARON RENEE (RN, DFM)
Entity type:Individual
Prefix:DR
First Name:CARON
Middle Name:RENEE
Last Name:DRAKE
Suffix:
Gender:F
Credentials:RN, DFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 STATE ROAD 19 # 1020
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-4231
Mailing Address - Country:US
Mailing Address - Phone:850-430-3302
Mailing Address - Fax:
Practice Address - Street 1:2010 STATE ROAD 19 # 1020
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-4231
Practice Address - Country:US
Practice Address - Phone:850-430-3302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9279905163W00000X
175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No175F00000XOther Service ProvidersNaturopath