| Randall B Rigdon Llc | |
|
270 N Sykes Creek Pkwy Suite 202 Merritt Island FL 32953-3492 | |
| (321) 454-2468 | |
| (321) 454-2469 |
| Full Name | Randall B Rigdon Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 270 N Sykes Creek Pkwy, Merritt Island, Florida |
| Authorized Official Name and Position | Randall B. Rigdon (PHYSICIAN) |
| Authorized Official Contact | 3215363634 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randall B Rigdon Llc 270 N Sykes Creek Pkwy Suite 202 Merritt Island FL 32953-3492 Ph: (321) 454-2468 | Randall B Rigdon Llc 270 N Sykes Creek Pkwy Suite 202 Merritt Island FL 32953-3492 Ph: (321) 454-2468 |
| NPI Number | 1982892501 |
|---|---|
| Provider Enumeration Date | 10/09/2007 |
| Last Update Date | 10/09/2007 |
| Medicare PECOS PAC ID | 8921189002 |
|---|---|
| Medicare Enrollment ID | O20080115000287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982892501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME75248 (Florida) | Primary |
| Provider Name | Randall Rigdon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396791455 PECOS PAC ID: 8224119300 Enrollment ID: I20080115000272 |
| Provider Name | David E Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861043648 PECOS PAC ID: 4183053283 Enrollment ID: I20200409003505 |
| Provider Name | Trisha Lorraine White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760909766 PECOS PAC ID: 8022439090 Enrollment ID: I20200709000298 |
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