Provider Demographics
NPI:1548798044
Name:MING, RANDY STEVE
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:STEVE
Last Name:MING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 W LUCERNE CIR APT 912
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3792
Mailing Address - Country:US
Mailing Address - Phone:407-450-4936
Mailing Address - Fax:407-386-7063
Practice Address - Street 1:20 W LUCERNE CIR APT 912
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3792
Practice Address - Country:US
Practice Address - Phone:407-450-4936
Practice Address - Fax:407-386-7063
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty