Individual
MRS. LESLIE ANGELETTE RANDOLPH-MOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPAS, PA-C
Contact information
Practice address
4600 MIDDLETON PARK CIR E APT D250, JACKSONVILLE, FL 32224-4684
(090) 461-0339
Mailing address
116 CLARENDON RD, ST JOHNS, FL 32259-7079
(785) 226-2115
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1061708
KS
363AM0700X
Medical Physician Assistant
Primary
PA9113425
FL
Other
Enumeration date
09/11/2006
Last updated
10/18/2023
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