MEDICARE: MR. RANDY LEE KENT AP, RN

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	171100000X	Acupuncturist	AP1960	FL

General Provider Information

NPI Number	:	1457576894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RANDY LEE KENT AP, RN

Provider Business Mailing Address
First Line	:	625 N WASHINGTON BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-4241
Country	:	US
Telephone Number	:	941-363-9000
Fax Number	:	941-951-1808

Provider Business Practice Location Address
First Line	:	625 N WASHINGTON BLVD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-4241
Country	:	US
Telephone Number	:	941-363-9000
Fax Number	:	941-951-1808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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