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General NPI Number Information
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NPI Number | 1235124207
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Entity Type | Individual
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Provider Name | RANDY ESTACION FLORENDO MD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 832 SAVANNAH WEST CT SUITE F
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City | SPRINGFIELD
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State | TN
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Zip | 37172
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Country | US
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Telephone | 615-483-6675
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Fax |
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Provider Business Mailing Address
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Address Line | 832 SAVANNAH WEST CT SUITE F
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City | SPRINGFIELD
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State | TN
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Zip | 37172-7387
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Country | US
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Telephone | 615-643-5008
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Fax | 615-643-4100
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD31309
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD31309
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 49518
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 31309
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 49518
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License Number State | KY
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD31309
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License Number State | TN
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