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NPI Code Detail

MEDICARE: DR. ALLISON J RANDALL PHARM.D

MEDICARE: DR. ALLISON J RANDALL PHARM.D
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
1183500000XPharmacistPS44135FL

General Provider Information

NPI Number : 1386924983
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLISON J RANDALL PHARM.D
Provider Business Mailing Address
First Line : 5641 MONTILLA DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-3411
Country : US
Telephone Number : 401-487-3934
Fax Number :
Provider Business Practice Location Address
First Line : 6790 DANIELS PKWY
Second Line :
City : FORT MYERS
State : FL
Zip : 33912-7521
Country : US
Telephone Number : 239-433-4091
Fax Number : 239-433-4920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2011
Last Update Date : 08/26/2011

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