Provider Demographics
NPI:1609335272
Name:HUGHES, RANDALL JAMES
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:JAMES
Last Name:HUGHES
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 1:5465 CURRY FORD RD APT B103
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8509
Mailing Address - Country:US
Mailing Address - Phone:256-860-2329
Mailing Address - Fax:
Practice Address - Street 1:5465 CURRY FORD RD APT B103
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-8509
Practice Address - Country:US
Practice Address - Phone:256-860-2329
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH220730931410OtherID