Provider Demographics
NPI:1326571142
Name:RANDO SOUS, ALBERTO IGNACIO (MD)
Entity Type:Individual
Prefix:
First Name:ALBERTO
Middle Name:IGNACIO
Last Name:RANDO SOUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 227682
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33222-7682
Mailing Address - Country:US
Mailing Address - Phone:786-612-1472
Mailing Address - Fax:
Practice Address - Street 1:12260 SW 8TH ST STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33184-1544
Practice Address - Country:US
Practice Address - Phone:305-912-8540
Practice Address - Fax:305-912-8539
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME147060207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME147060OtherSTATE LICENSE