Active NPI
Robert Joseph Renna, R.PH.
- Pharmacist
- Lakeland, FL
National Provider Identifier
1255628053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0012013
- Practice address
- 3570 Harden Blvd
T1299
Lakeland, FL 33803-5928 - Phone
- (863) 648-0512
- Fax
- (863) 648-0512
- NPI assigned
- Jun 30, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS0012013 | FL | Primary |
Addresses
Primary practice location
3570 Harden Blvd
T1299
Lakeland, FL 33803-5928
Mailing address
3570 Harden Blvd
T1299
Lakeland, FL 33803-5928
Phone (863) 648-0512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS0012013 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309392000000",
"number": "1255628053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3570 HARDEN BLVD",
"address_2": "T1299",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338035928",
"telephone_number": "863-648-0512",
"fax_number": "863-648-0512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 HARDEN BLVD",
"address_2": "T1299",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338035928",
"telephone_number": "863-648-0512",
"fax_number": "863-648-0512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENNA",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-30",
"last_updated": "2011-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0012013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.