Organization
CLEVELAND W RANDOLPH, JR, MD, PA
Active
Other names
Dr. Randolph's Ageless & Wellness Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA LOUISE GALLER (PRACTICE ADMINISTRATOR)
(904) 249-3743
Entity
Organization
Contact information
Practice address
1891 BEACH BLVD STE 200, JACKSONVILLE BEACH, FL 32250-2644
(904) 249-3743
(904) 249-2047
Mailing address
1891 BEACH BLVD STE 200, JACKSONVILLE BEACH, FL 32250-2644
(904) 249-3743
(904) 249-2047
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0042493
FL
Other
Enumeration date
01/18/2007
Last updated
12/01/2025
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