Organization
CENTRAL FLORIDA PATHOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L RANDELL M.D. (PRESIDENT)
(407) 303-6611
Entity
Organization
Contact information
Practice address
601 E ROLLINS ST, DEPT. OF PATHOLOGY, ORLANDO, FL 32803-1248
(404) 303-6611
Mailing address
PO BOX 140987, ORLANDO, FL 32814-0987
(407) 422-9831
(407) 648-2065
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
253421500
—
FL
01
—
CN6381
RAILROAD MEDICARE
—
Enumeration date
11/19/2005
Last updated
01/16/2012
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