Individual
THERESA RANDAZZO-BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 697-3600
(904) 697-3792
Mailing address
PO BOX 191, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
200701651
NC
2084P0800X
Psychiatry Physician
218786
MA
2084P0804X
Child & Adolescent Psychiatry Physician
200701651
NC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME119289
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5910414
—
NC
Enumeration date
02/23/2007
Last updated
05/16/2014
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