David Charles Randall, MPT | |
527 Avenue B, Melbourne Beach, FL 32951-2216 | |
(321) 482-4982 | |
Not Available |
Full Name | David Charles Randall |
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Gender | Male |
Speciality | Physical Therapist |
Location | 527 Avenue B, Melbourne Beach, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952842742 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT22170 (Florida) | Primary |
Provider Name | Us Health Dept Of Health & Human Services |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1972694602 PECOS PAC ID: 9638081623 Enrollment ID: O20031106000399 |
Mailing Address | Practice Location Address |
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David Charles Randall, MPT 527 Avenue B, Melbourne Beach, FL 32951-2216 Ph: () - | David Charles Randall, MPT 527 Avenue B, Melbourne Beach, FL 32951-2216 Ph: (321) 482-4982 |
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