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Individual

SHAHID RASUL RANDHAWA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2510 E OAKLAND PARK BLVD, FORT LAUDERDALE, FL 33306-1601
(954) 717-1919
(954) 717-2528
Mailing address
5333 N DIXIE HWY, STE 109, OAKLAND PARK, FL 33334-3453
(954) 717-1919
(954) 717-2528

Taxonomy

Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
ME92264
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003737500
FL
01
16010
BCBS
FL
Enumeration date
10/19/2005
Last updated
11/05/2021
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