RANDOLPH DIABETES AND WELLNESS LLC (NPI# 1609378991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609378991 |
Entity Type | Organization |
Organization Name | RANDOLPH DIABETES AND WELLNESS LLC |
Practice Address |
8017 Savannah Sunset Ln Tampa FL 33615-1388 |
Practice Telephone | 8138467698 |
Enumeration Date | 2018-03-02 |
Last Update Date | 2019-08-20 |
Authorized Official Name | MS. KIMBERLY T RANDOLPH (OWNER/MANAGER) |
Authorized Official Telephone | 8138467698 |
Authorized Official Credential | ARNP-C |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP9318390 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
Street Address |
8017 SAVANNAH SUNSET LN |
City | TAMPA |
State | FL |
Zip Code | 33615-1388 |
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1235671785 | Magnet Home Health Care Services, LLC | Home Health | 5700 Memorial Highway Suite G X H 102, Tampa, FL 33615 | 2016-11-15 |
1891247532 | Martin Esuzor | Nurse Practitioner | 7918 Hillsborough Avenue, Tampa, FL 33615 | 2016-10-28 |
1902263007 | Marie E. Simeon | Nursing Facility/Intermediate Care Facility | 8206 Pennywell Place, Tampa, FL 33615 | 2016-01-20 |
1598183659 | Mustafa Mohammad | Dermatology | 6001 Memorial Highway, Tampa, FL 33615 | 2014-04-04 |
1710327101 | Kelly A Alvarez | Case Manager/Care Coordinator | 7007 Cobblewood Ct, Tampa, FL 33615 | 2013-06-28 |
1336497080 | Serenity Home of Tampa Alf LLC | Assisted Living Facility | 6013 Cresthill Drive, Tampa, FL 33615 | 2012-08-28 |
1063777563 | Jaime Alexander Pacheco | Chiropractor | 6301 Memorial Hwy Suit 304, Tampa, FL 33615 | 2012-07-10 |
1558656678 | Scripts Direct, LLC | Pharmacy | 8313 W. Hillsborough Ave., # 260, Tampa, FL 33615 | 2011-06-16 |
1508178245 | The Spring of Tampa Bay | Counselor | 2810 N. 35 St, Tampa, FL 33615 | 2010-07-10 |
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Taxonomy Code | 261QH0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Health Service |
Definition to come... |
Notes: [7/1/2006: modified title] |
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1134539273 | Lotus Path Wellness Center | Clinic/Center | 3642 Madaca Ln, Tampa, FL 33618-2057 | 2014-04-29 |
1689091050 | Dcreasequeen, Inc. | Clinic/Center | 11634 Bristol Chase Dr, Tampa, FL 33626-3300 | 2014-03-24 |
1790127249 | Ferrer Medical Center | Clinic/Center | 8313 W Hillsborough Ave Ste 260, Tampa, FL 33615-3818 | 2013-07-25 |
1205278264 | Century Health Center | Clinic/Center | 7402 N 56th St Bldg 900, Suite 907, Tampa, FL 33617-7733 | 2013-07-18 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.