MEDICARE: H.E.R.O. INSTITUTE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency
2	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	RN199251	OTHER	GA	NP LICENSE NUMBER

General Provider Information

NPI Number	:	1316643315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H.E.R.O. INSTITUTE LLC

Provider Business Mailing Address
First Line	:	2847 VETERANS MEMORIAL HWY SW UNIT 1322
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-1113
Country	:	US
Telephone Number	:	770-726-3577
Fax Number	:	770-522-6228

Provider Business Practice Location Address
First Line	:	6130 HOTEL ST
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30106-4623
Country	:	US
Telephone Number	:	770-726-3577
Fax Number	:	770-522-6228

Authorized Official
Title or Position	:	PROVIDER
Name	:	MRS. VICTORIA RANDLE
Credential	:	NP-C
Telephone Number	:	770-726-3577

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	02/22/2026

Similar Medicare Providers

1083083810 — VICTORIA RANDLE FNP-C
Practice Location Address:

6130 HOTEL ST
AUSTELL, GA
30106-4623

Practice Phone: 770-726-3577
Practice Fax: 770-522-6228

1619821394 — TRUC MY THI DAO PA-C
Practice Location Address:

2615 E WEST CONNECTOR STE 106
AUSTELL, GA
30106-6854

Practice Phone: 770-941-0010
Practice Fax: 770-941-0154

1295686822 — JACOB KING
Practice Location Address:

3950 AUSTELL RD
AUSTELL, GA
30106-1121

Practice Phone: 770-732-4000
Practice Fax:

1205788643 — DR. LORRIE LAY
Practice Location Address:

3640 TRAMORE POINTE PKWY
AUSTELL, GA
30106-6825

Practice Phone: 770-439-4703
Practice Fax:

1679425458 — AMINAH MARIE DIAGNE RN
Practice Location Address:

3950 AUSTELL RD
AUSTELL, GA
30106-1121

Practice Phone: 770-732-4000
Practice Fax:

1073595716 — CESAR AUGUSTO ANGELETTI MD
Practice Location Address:

3950 AUSTELL RD , DEPARTMENT OF PATHOLOGY
AUSTELL, GA
30106-1121

Practice Phone: 470-732-3585
Practice Fax: 470-732-3565

Directions to “H.E.R.O. INSTITUTE LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.