Provider Demographics
NPI:1679014096
Name:RENAULT, CHRISTINA (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:RENAULT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8753 ASHWORTH DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2269
Mailing Address - Country:US
Mailing Address - Phone:813-994-1926
Mailing Address - Fax:
Practice Address - Street 1:8753 ASHWORTH DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2269
Practice Address - Country:US
Practice Address - Phone:813-994-1926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist