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Individual
MR. RANDALL S FORTUNA
Active
Individual
MR. RANDALL S FORTUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
036-109764
IL
2086S0129X
Vascular Surgery Physician
036109764
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036109764
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
49534
AZ
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A68643
CA
Other
Enumeration date
02/12/2006
Last updated
10/31/2023
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