Individual
MS. KIMBERLY T RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP-C
Contact information
Practice address
13047 W LINEBAUGH AVE STE 102, TAMPA, FL 33626-4487
(813) 475-6542
Mailing address
13047 W LINEBAUGH AVE STE 102, TAMPA, FL 33626-4487
(813) 475-6542
(813) 475-6874
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP9318390
FL
Other
Enumeration date
10/02/2013
Last updated
08/19/2021
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