Provider Demographics
NPI:1023003100
Name:RODRIGUES, RANDI-ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:RANDI-ANN
Middle Name:
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 RED BUG LAKE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9226
Mailing Address - Country:US
Mailing Address - Phone:407-366-6004
Mailing Address - Fax:407-366-6919
Practice Address - Street 1:8000 RED BUG LAKE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9226
Practice Address - Country:US
Practice Address - Phone:407-366-6004
Practice Address - Fax:407-366-6919
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8482207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6699260OtherCIGNA
FL131312OtherHUMANA
FL293284OtherAMERIGROUP
FL17512OtherFHHS
FL161676734OtherUNITED HEALTHCARE
FL284361OtherAVMED
FL268921900Medicaid
FL584112OtherAETNA
FL62826OtherBCBS
FL14434701OtherCITRUS
FLH79887Medicare UPIN