Provider Demographics
NPI:1598535841
Name:ACOFF, AYANNA JANAI
Entity Type:Individual
Prefix:
First Name:AYANNA
Middle Name:JANAI
Last Name:ACOFF
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 1:5032 CAPITAL CIR SW
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-7685
Mailing Address - Country:US
Mailing Address - Phone:850-878-1740
Mailing Address - Fax:
Practice Address - Street 1:5032 CAPITAL CIR SW
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32305-7685
Practice Address - Country:US
Practice Address - Phone:850-878-1740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL66623183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist