Healthcare Provider Details

I. General information

NPI: 1457538514
Provider Name (Legal Business Name): RANDALL KEITH REDFERN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RANDY KEITH REDFERN CRNA

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 07/31/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

13041 NW 1ST ST APT 304
PEMBROKE PINES FL
33028-2292
US

V. Phone/Fax

Practice location:
  • Phone: 786-596-4947
  • Fax:
Mailing address:
  • Phone: 850-508-2635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9213326
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: