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NPI Code Detail

MEDICARE: RANDY R. REESE M.D.

MEDICARE: RANDY R. REESE M.D.
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
1207Q00000XFamily Medicine PhysicianME0034740FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080040384OTHERFLRAIL ROAD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083654693
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY R. REESE M.D.
Provider Business Mailing Address
First Line : 2907 KERRY FOREST PKWY
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-6825
Country : US
Telephone Number : 850-668-3380
Fax Number : 850-668-3226
Provider Business Practice Location Address
First Line : 2907 KERRY FOREST PKWY
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-6825
Country : US
Telephone Number : 850-668-3380
Fax Number : 850-668-3226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 05/07/2015

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