Individual
DR. MIAKISH RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 470-6900
Mailing address
6900 SOUTHPOINT DR N FL 5, JACKSONVILLE, FL 32216-8007
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
03/03/2022
Last updated
03/11/2022
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