Individual
DR. BETTY G RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD, CCC-A
Contact information
Practice address
3310 LAKELAND HILLS BLVD, LAKELAND, FL 33805-1974
(863) 802-6600
(863) 802-6639
Mailing address
515 EAST GARDEN STREET, LAKELAND, FL 33805
(863) 683-5454
(863) 683-4652
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AY1375
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600538100
—
FL
01
—
AF241Z
MEDICARE
FL
Enumeration date
08/14/2007
Last updated
06/04/2021
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