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NPI Code Detail

MEDICARE: RANDALL ALLEN CARTER PA-C

MEDICARE: RANDALL ALLEN CARTER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant1045OK
2363AM0700XMedical Physician AssistantPA9118770FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11045OTHEROKOKLAHOMA BOARD OF MEDICAL LICENSURE

General Provider Information

NPI Number : 1073559373
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDALL ALLEN CARTER PA-C
Provider Business Mailing Address
First Line : 6909 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33634-2213
Country : US
Telephone Number : 813-999-1163
Fax Number : 813-999-1073
Provider Business Practice Location Address
First Line : 6909 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33634-2213
Country : US
Telephone Number : 813-999-1163
Fax Number : 813-999-1073
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2006
Last Update Date : 02/27/2025

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Directions to “ RANDALL ALLEN CARTER PA-C” Practice Location

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