# ANDREW J. RANDOLPH MD PA

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

## Provider details

- **NPI number:** 1720381833
- **Authorized official:** DR. ANDREW J RANDOLPH (PRESIDENT)
- **Authorized official phone:** (386) 734-4453

## Contact information

- **Practice address:** 1025 N STONE ST STE B, DELAND, FL 32720-0803
- **Practice address phone:** (386) 734-4453
- **Mailing address:** 1025 N STONE ST STE B, DELAND, FL 32720-0803

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/10/2010
- **Last updated:** 12/10/2010