| Andrew J. Randolph Md Pa | |
|
1025 N Stone St Ste B Deland FL 32720-0803 | |
| (386) 734-4453 | |
| Not Available |
| Full Name | Andrew J. Randolph Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1025 N Stone St Ste B, Deland, Florida |
| Authorized Official Name and Position | Andrew J Randolph (PRESIDENT) |
| Authorized Official Contact | 3867344453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew J. Randolph Md Pa 1025 N Stone St Ste B Deland FL 32720-0803 Ph: () - | Andrew J. Randolph Md Pa 1025 N Stone St Ste B Deland FL 32720-0803 Ph: (386) 734-4453 |
| NPI Number | 1720381833 |
|---|---|
| Provider Enumeration Date | 12/10/2010 |
| Last Update Date | 12/10/2010 |
| Medicare PECOS PAC ID | 9537348867 |
|---|---|
| Medicare Enrollment ID | O20110119000603 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720381833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Andrew J Randolph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982775706 PECOS PAC ID: 1254510597 Enrollment ID: I20110119000755 |
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