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NPI Code Detail

MEDICARE: RANDA EDELBI OD

MEDICARE:   RANDA  EDELBI  OD
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
1152W00000XOptometrist2003-949ATLA
2152W00000XOptometrist0618002757VA
3152W00000XOptometristOPC5654FL

General Provider Information

NPI Number : 1710546452
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDA EDELBI OD
Provider Business Mailing Address
First Line : 11353 ANDREW LN
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-5507
Country : US
Telephone Number : 571-268-4391
Fax Number :
Provider Business Practice Location Address
First Line : 3808 E COLONIAL DR
Second Line :
City : ORLANDO
State : FL
Zip : 32803-5208
Country : US
Telephone Number : 703-961-9119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2019
Last Update Date : 08/04/2023

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Directions to “ RANDA EDELBI OD” Practice Location

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