Individual
RANDOLPH EDWARD ALLEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2387 RAMSDALE DR SE, PALM BAY, FL 32909-6492
(321) 951-0754
Mailing address
2387 RAMSDALE DR SE, PALM BAY, FL 32909
(321) 951-0754
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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