Provider Demographics
NPI:1659178119
Name:CORINTHIAN, RANDY
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:
Last Name:CORINTHIAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 NW 39TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4447
Mailing Address - Country:US
Mailing Address - Phone:954-324-7299
Mailing Address - Fax:
Practice Address - Street 1:821 NW 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-7205
Practice Address - Country:US
Practice Address - Phone:954-324-7299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator