Randi Bloom-Brazer in St Augustine - Clinical
Randi Bloom-Brazer - NPI 1740466929
Randi Bloom-Brazer is a Clinical in St Augustine, Florida. Randi Bloom-Brazer practices all healthcare services and medical treatments related to Clinical. The NPI Number for Randi Bloom-Brazer is 1740466929. The last update date is 2008-01-17.
Randi Bloom-Brazer's current location address is 165 Southpark Blvd, St Augustine, Florida. You can contact this provider via phone number 9048247597 and fax number 9048247598. The mailing address for Randi Bloom-Brazer is 165 Southpark Blvd, St Augustine, Florida. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randi Bloom-Brazer |
|---|---|
| Address | 165 Southpark Blvd, St Augustine, Florida |
| Phone Number | 9048247597 |
| Fax Number | 9048247598 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1740466929 |
|---|---|
| Provider Enumeration Date | 2008-01-17 |
| Last Updated Date | 2008-01-17 |
Provider Mailing Address Detail
| Address | 165 Southpark Blvd |
|---|---|
| City | St Augustine |
| State | Florida (FL) |
| Post Code | 320864101 |
| Phone Number | 9048247597 |
| Fax Number | 9048247598 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | SW 5042 |
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What is the unique 10-digit identification code issued to Randi Bloom-Brazer by the Centers for Medicare & Medicaid Services?
The Randi Bloom-Brazer has been assigned the NPI (National Provider Identifier) 1740466929 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Randi Bloom-Brazer's facilities are situated?
The facilities of Randi Bloom-Brazer are physically located at the following address: 165 Southpark Blvd, St Augustine, FL, 320864101.
What is Randi Bloom-Brazer's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Randi Bloom-Brazer is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1740466929 to Randi Bloom-Brazer?
The Randi Bloom-Brazer received its 1740466929 assignment from the Centers for Medicare & Medicaid Services on 2008-01-17.
As of what date were the details pertaining to Randi Bloom-Brazer last refreshed?
The information related to the Randi Bloom-Brazer, including its address, specialty, and other relevant details, was last updated on 2008-01-17.
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