MEDICARE: WILLIAM J RAND MDPA

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	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1528010980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM J RAND MDPA

Provider Business Mailing Address
First Line	:	5 W SAMPLE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3542
Country	:	US
Telephone Number	:	954-782-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 W SAMPLE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-3542
Country	:	US
Telephone Number	:	954-782-1700
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DEBORAH G RAND
Credential	:
Telephone Number	:	954-782-1700

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	12/13/2007

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