LESLEY RANDOLL (NPI# 1104240035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104240035 |
| Entity Type | Individual |
| Full Name | LESLEY RANDOLL |
| Credential | APRN |
| Practice Address |
831 Simpson Rd Kissimmee FL 34744-5328 |
| Practice Telephone | 4074835757 |
| Practice Fax Number | 4073505291 |
| Mailing Telephone | 4074835757 |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2020-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
APRN11002450 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
2014003661 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
2014003661 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BOARD OF NURSING LICENSE | APRN11002450 | 01 |
| MO | BOARD OF NURSING LICENSE | 2014003661 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1611 S Baltimore St, Kirksville, MO 635014536 | 6606657575 | 6606657576 |
| 800 Hospital Dr, Columbia, MO 652015275 | 5738146000 |
| Street Address |
831 SIMPSON RD |
| City | KISSIMMEE |
| State | FL |
| Zip Code | 34744-5328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760754170 | Jason Tyler Cirolia | Physical Therapist | 831 Simpson Rd, Kissimmee, FL 34744-5328 | 2012-01-31 |
| 1760035513 | Interra Health Inc. | Clinic/Center | 831 Simpson Rd, Kissimmee, FL 34744-5328 | 2019-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003416843 | Guidewell Emergency Medicine Doctors, LLC | Clinic/Center | 2465 N Orange Blossom Trail, Kissimmee, FL 34744 | 2020-10-30 |
| 1871126722 | Orlando Therapy Services LLC | Speech-Language Pathologist | 2815 Flamvoyan Street, Kissimmee, FL 34744 | 2020-02-19 |
| 1083197941 | Marilyn Mendez | Behavior Technician | 678 Cornestone Dr, Kissimmee, FL 34744 | 2018-09-07 |
| 1255827309 | St.cloud Pharmacy&wellness Center | Pharmacy | St.cloud Pharmacy & Wellness Center, 1503, Billbeck Blvd, Kissimmee, FL 34744 | 2018-07-02 |
| 1518454966 | Nationwide Vision Center, LLC | Technician/Technologist | 2376 E Irlo Bronson Memorial Highway, Kissimmee, FL 34744 | 2018-04-20 |
| 1831698661 | Ramirez and Poulos M.d. P.a. | Ophthalmology | 809 E. Oak St, Suite - 202, Kissimmee, FL 34744 | 2018-02-07 |
| 1548702517 | Laura L Wheeler | Counselor | 600 N Thacker, D63, Kissimmee, FL 34744 | 2016-11-08 |
| 1275992950 | Judith Ambrose | Case Management | 1320 N Main Street, Suite B, Saint Cloud, FL 34744 | 2016-02-23 |
| 1043685258 | Oreida Hernandez De Morissette | Case Management | 809 E. Oak Street, Suite 106, Kissimmee, FL 34744 | 2015-12-14 |
| 1780062232 | Martin Alfredo Rosell | Hearing Instrument Specialist | 806 N Main Street, Kissimmee, FL 34744 | 2015-05-15 |
| Find all providers in zip 34744 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235687625 | Cambridge Healthcare Providers | Nurse Practitioner | 2017 Traders Cv, Kissimmee, FL 34743-7828 | 2016-09-14 |
| 1942843149 | Leslie Nicole Clemons | Nurse Practitioner | 2550 Simpson Rd, Kissimmee, FL 34744-4637 | 2019-10-21 |
| 1043872229 | Jessie M Swisher | Nurse Practitioner | 700 W Oak St, Kissimmee, FL 34741-4996 | 2019-07-08 |
| 1760982052 | Priscilla Yvette Mercado | Nurse Practitioner | 1819 W Oak St, Kissimmee, FL 34741-4077 | 2018-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871724 | Brenna Schulman | Nurse Practitioner | 6859 Sw 18th St Ste 200, Boca Raton, FL 33433-7015 | 2020-11-04 |
| 1245831726 | Sydia Spence | Nurse Practitioner | 8001 Nw 66th Ter, Tamarac, FL 33321-7015 | 2020-11-02 |
| 1598365165 | Fernande Simeon | Nurse Practitioner | 6490 Nw 55th St, Coral Springs, FL 33067-2710 | 2020-10-31 |
| 1780284596 | Corrective Spinal Care Inc | Nurse Practitioner | 6965 Piazza Grande Ave Ste 207, Orlando, FL 32835-8780 | 2020-10-30 |
| 1023617420 | John Bertram Garrett Iv | Nurse Practitioner | 5079 Garrett Rd, Malone, FL 32445-3409 | 2020-10-19 |
| 1518565894 | Karen Giselle Reyes | Nurse Practitioner | 4563 Perth Rd, West Palm Beach, FL 33415-2811 | 2020-10-09 |
| 1265039424 | Catherine Dettelbach Lake | Nurse Practitioner | 3411 Shenandoah Dr W, Orange Park, FL 32073-6631 | 2020-10-01 |
| 1417562877 | Victoria Ann Jacobs | Nurse Practitioner | 3605 Lithia Ridge Blvd, Valrico, FL 33596-6482 | 2020-09-12 |
| 1760096135 | Conciergenp | Nurse Practitioner | 1221 S 23rd Ave, Hollywood, FL 33020-5912 | 2020-09-03 |
| 1649881434 | Dr Jose A Rivera LLC | Nurse Practitioner | 110 W Citrus St, Altamonte Springs, FL 32714-2502 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.