Individual
DR. ANDREA LEE RANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2770 CAPITAL MEDICAL BLVD STE 200, TALLAHASSEE, FL 32308-8419
(850) 878-8235
(850) 878-1899
Mailing address
2770 CAPITAL MEDICAL BLVD STE 200, TALLAHASSEE, FL 32308-8419
(850) 878-8235
(850) 878-1899
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME59307
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000531759B
—
GA
05
—
05263470
—
FL
01
—
11907
BCBS INDIVIDUAL NUMBER
FL
01
—
99039
GROUP BCBS NUMBER
FL
01
—
P00625815
RAILROAD MEDICARE
FL
Enumeration date
05/24/2005
Last updated
02/09/2022
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