Randolph, Andrew Jerome

Randolph, Andrew Jerome is an sole proprietor health care provider with primary practice located at 1025 N Stone St Suite B, Deland FL 32720-0803. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Randolph, Andrew Jerome can be contacted via phone (386) 734-4453.

Contact Information

Primary practice address
1025 N Stone St Suite B Deland FL 32720-0803
Phone: (386) 734-4453
Fax: (386) 734-1130
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 49576 Florida

Profile Details

NPI number 1982775706
LBN Legal business name Randolph, Andrew Jerome
Credentials M.D., P.A.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 13th, 2006
Last updated Jul 9th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1982775706 NPPES
Florida Other 10718618 CAQH PROVIDER #
Florida MEDICAID 044348400 CAQH PROVIDER #
Florida Other 592870603 CAQH PROVIDER #
Florida Other 02590 CAQH PROVIDER #

Popular Providers