Individual
MS. KATHERINE G RANDOLPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4801 SWIFT RD, SUITE I, SARASOTA, FL 34231-5139
(941) 320-3391
Mailing address
2319 SPRING OAKS CIR, SARASOTA, FL 34234-4962
(941) 360-9846
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA32332
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C7448
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/20/2007
Last updated
07/08/2007
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