| Randolph Diabetes And Wellness Llc | |
|
13047 W Linebaugh Ave Ste 102 Tampa FL 33626-4487 | |
| (813) 475-6542 | |
| (813) 475-6874 |
| Full Name | Randolph Diabetes And Wellness Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 13047 W Linebaugh Ave Ste 102, Tampa, Florida |
| Authorized Official Name and Position | Kimberly T Randolph (OWNER/MANAGER) |
| Authorized Official Contact | 8138467698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randolph Diabetes And Wellness Llc 13047 W Linebaugh Ave Ste 102 Tampa FL 33626-4487 Ph: (813) 475-6542 | Randolph Diabetes And Wellness Llc 13047 W Linebaugh Ave Ste 102 Tampa FL 33626-4487 Ph: (813) 475-6542 |
| NPI Number | 1609378991 |
|---|---|
| Provider Enumeration Date | 03/02/2018 |
| Last Update Date | 05/12/2021 |
| Medicare PECOS PAC ID | 5799184032 |
|---|---|
| Medicare Enrollment ID | O20210519000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609378991 | NPI | - | NPPES |
| Provider Name | Kimberly Randolph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457788671 PECOS PAC ID: 2961710587 Enrollment ID: I20151001001054 |
Main St Medical Usa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11734 North Dale Mabry, Tampa, FL 33618 Phone: 813-968-6000 Fax: 813-968-6007 | |
Infante Medical Office Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4712 N Armenia Ave, Suite 102, Tampa, FL 33603 Phone: 813-873-1725 Fax: 813-873-2924 | |
After Care Centers Of Florida Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3424 W Kennedy Blvd, Tampa, FL 33609 Phone: 855-716-3342 | |
Eugene A Ward M.d. Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3450 E Fletcher Avenue, Suite 310, Tampa, FL 33613 Phone: 813-972-1654 Fax: 813-972-7176 | |
Sarroca Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3709 W Hamilton Ave, Unit 9., Tampa, FL 33614 Phone: 813-374-7608 Fax: 813-374-9124 | |
Simmons Medical Group South Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 301 Harbour Place Dr Unit 2007, Tampa, FL 33602 Phone: 248-321-6612 Fax: 813-964-6337 | |
N/a Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3225 S Macdill Ave Ste 129-313, Tampa, FL 33629 Phone: 813-200-8857 Fax: 813-200-1319 |