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General NPI Number Information
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NPI Number | 1194352096
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Entity Type | Individual
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Provider Name | RANDY ENCIO DO
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Gender | Male
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 03/23/2020
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Provider Practice Location Address
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Address Line | 12800 BISCAYNE BLVD.
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City | NORTH MIAMI
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State | FL
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Zip | 33181-3318
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Country | US
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Telephone | 305-913-2276
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Fax |
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Provider Business Mailing Address
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Address Line | 6630 COOLIDGE ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-3917
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Country | US
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Telephone | 305-331-0339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS60599
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License Number State | FL
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