Provider Demographics
NPI:1821496563
Name:HOYT, RANDINA (IBCLC)
Entity Type:Individual
Prefix:
First Name:RANDINA
Middle Name:
Last Name:HOYT
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13710 DEVAN LEE DR E
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-5812
Mailing Address - Country:US
Mailing Address - Phone:719-659-3939
Mailing Address - Fax:
Practice Address - Street 1:13710 DEVAN LEE DR E
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32226-5812
Practice Address - Country:US
Practice Address - Phone:196-593-9397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-11
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-302295174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty