Individual
DR. RANDALL THOMAS RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5151 WINTER GARDEN VINELAND RD STE 206, WINDERMERE, FL 34786-6098
(407) 573-3360
(407) 643-2811
Mailing address
5151 WINTER GARDEN VINELAND RD STE 206, WINDERMERE, FL 34786-6098
(407) 573-3360
(407) 643-2811
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME100461
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003892600
—
FL
01
—
01440170
AMERIGROUP
—
01
—
1497R
BCBS
—
01
—
3195285
UNITED HEALTHCARE
—
01
—
348451
AVMED
—
01
—
622976
WELLCARE
—
01
—
7534257
CIGNA
—
01
—
9605661
AETNA
—
01
—
P992885
FREEDOM
—
Enumeration date
12/12/2007
Last updated
11/24/2020
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