Healthcare Provider Details

I. General information

NPI: 1801897889
Provider Name (Legal Business Name): RANDALL F RANDAZZO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JAMES A HALEY VETERANS' HOSPITAL 13000 BRUCE B DOWNS, BUILDING 1
TAMPA FL
33612-4745
US

IV. Provider business mailing address

13000 BRUCE B DOWNS BLVD BUILDING 1 A3-304
TAMPA FL
33612-4745
US

V. Phone/Fax

Practice location:
  • Phone: 813-972-2000
  • Fax: 847-466-7936
Mailing address:
  • Phone: 813-972-2000
  • Fax: 847-466-7936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number036-077481
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: