Individual
MR. JOSEPH C RANDAZZO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2727 W DR MARTIN LUTHER KING JR BLVD STE 320, TAMPA, FL 33607-6055
(813) 877-6748
(813) 875-0359
Mailing address
2727 W DR MARTIN LUTHER KING JR BLVD STE 320, TAMPA, FL 33607-6055
(813) 877-6748
(813) 875-0359
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9112498
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104526300
—
FL
Enumeration date
09/11/2019
Last updated
09/10/2024
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