Individual
DUSTIN JEFF RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
703 N FLAMINGO RD, PEMBROKE PINES, FL 33028-1014
(954) 436-5000
Mailing address
1700 FRUITLAND DR, OGDEN, UT 84414-2989
(801) 645-9584
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
14275295-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2022
Last updated
04/07/2026
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