Healthcare Provider Details

I. General information

NPI: 1033418843
Provider Name (Legal Business Name): RANDHIR JESUDOSS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38135 MARKET SQUARE DR STE 101
ZEPHYRHILLS FL
33542-7505
US

IV. Provider business mailing address

38135 MARKET SQUARE DR
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 813-780-7534
  • Fax: 813-335-5033
Mailing address:
  • Phone: 813-778-0425
  • Fax: 813-335-5033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberMD41902
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD41902
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License NumberMA41902
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: