Provider Demographics
NPI:1417260365
Name:RANDO, VANESSA (AUD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:RANDO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5411 N UNIVERSITY DR
Mailing Address - Street 2:STE 102
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4637
Mailing Address - Country:US
Mailing Address - Phone:954-752-1559
Mailing Address - Fax:954-752-1560
Practice Address - Street 1:5411 N UNIVERSITY DR
Practice Address - Street 2:STE 102
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4637
Practice Address - Country:US
Practice Address - Phone:954-752-1559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1628231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist