Active NPI
Rayna Danielle Wallace, PHARMD
- Pharmacy
- Cape Coral, FL
National Provider Identifier
1588454003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- PS67734
- Practice address
- 316 Del Prado Blvd S
Cape Coral, FL 33990-1710 - Phone
- (239) 226-2837
- NPI assigned
- May 8, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacy | 333600000X | PS67734 | FL | Primary |
Addresses
Primary practice location
316 Del Prado Blvd S
Cape Coral, FL 33990-1710
Mailing address
2632 Sam Hardwick Blvd
Jacksonville, FL 32246-3850
Phone (904) 566-1166
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS67734 | FL | MD | Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746662400000",
"number": "1588454003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2632 SAM HARDWICK BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322463850",
"telephone_number": "904-566-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 DEL PRADO BLVD S",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339901710",
"telephone_number": "239-226-2837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "RAYNA",
"middle_name": "DANIELLE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-05-08",
"last_updated": "2025-05-08",
"certification_date": "2025-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "FL",
"license": "PS67734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.