Healthcare Provider Details

I. General information

NPI: 1740110139
Provider Name (Legal Business Name): THOMAS W RANDLE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 NOTTINGHAM PL
BOYNTON BEACH FL
33426-8429
US

IV. Provider business mailing address

11390 TAFT ST
PEMBROKE PINES FL
33026-2140
US

V. Phone/Fax

Practice location:
  • Phone: 561-468-3039
  • Fax:
Mailing address:
  • Phone: 719-964-2113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT33027
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: