Provider Demographics
NPI:1407882897
Name:RANDY MEDICAL SERVICE INC
Entity Type:Organization
Organization Name:RANDY MEDICAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YURI
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-267-9132
Mailing Address - Street 1:5755 W FLAGLER ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-3441
Mailing Address - Country:US
Mailing Address - Phone:305-267-9132
Mailing Address - Fax:305-267-9132
Practice Address - Street 1:5755 W FLAGLER ST
Practice Address - Street 2:SUITE 208
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-3441
Practice Address - Country:US
Practice Address - Phone:305-267-9132
Practice Address - Fax:305-267-9132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5728210001Medicare NSC