# RANDY A GROVER O D & ASSOCIATES INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629285564
- **Authorized official:** RANDY A. GROVER O.D. (PRESIDENT)
- **Authorized official phone:** (305) 828-8393

## Contact information

- **Practice address:** 9300 NW 77TH AVE, HIALEAH GARDENS, FL 33016-2504
- **Practice address phone:** (305) 828-8393
- **Practice address fax:** (305) 828-8393
- **Mailing address:** 801 NE 191ST TER, MIAMI, FL 33179-3976
- **Mailing address phone:** (786) 338-3272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC 3543 | FL | Yes |

## Other

- **Enumeration date:** 05/17/2007
- **Last updated:** 11/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 621131300 | — | FL |