Organization
RANDALL L BRADDOM MD LLC
Active
Organization
RANDALL L BRADDOM MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL L BRADDOM MD (OWNER/PHYSICIAN)
(908) 601-7036
Entity
Organization
Contact information
Practice address
1451 EL CAMINO REAL, THE VILLAGES, FL 32159-0041
(352) 751-8000
Mailing address
1093 GOLDEN GROVE DR, THE VILLAGES, FL 32162-4023
(908) 601-7036
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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