Provider Demographics
NPI:1477635258
Name:TURNER, CECIL RANDOLPH (MD)
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:RANDOLPH
Last Name:TURNER
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 1:5064 CASTLEROCK WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-7926
Mailing Address - Country:US
Mailing Address - Phone:239-530-7494
Mailing Address - Fax:
Practice Address - Street 1:811 7TH AVE S
Practice Address - Street 2:SENIOR FRIENDSHIP CENTER
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-263-7425
Practice Address - Fax:239-263-3430
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLL530207Q00000X
GA027256207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBT-7848089OtherDEA FEDERAL GOVM (USA)