Individual
RANDOLPH ALEXANDER PANETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
399 9TH ST N STE 300, NAPLES, FL 34102-5820
(239) 624-4200
(239) 624-4241
Mailing address
399 9TH ST N STE 300, NAPLES, FL 34102-5820
(239) 624-4200
(239) 624-4241
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
044184
CT
207RC0000X
Cardiovascular Disease Physician
Primary
ME139310
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044184
LICENSE
CT
05
—
102508000
—
FL
01
—
B9C2F
BCBS
FL
Enumeration date
08/05/2006
Last updated
08/13/2019
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