Individual
RANDALL D COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Mailing address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP 2900442
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
768605600
—
FL
01
—
P01624084
RR MEDICARE
FL
01
—
Y015T
BC/BS FLORIDA BLUE
FL
Enumeration date
07/07/2006
Last updated
05/05/2021
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