Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E3857 | CA |
N | 222Z00000X | Podiatrist | E3857 | CA |
Y | 213ES0131X | Foot Surgery | E3857 | CA |
NPI | 1376548636 |
---|---|
Provider Name | Dr. Randi D Margolis |
First Address | Delray Beach, FL 33445-1284 |
Second Address | Delray Beach, FL 33445-1284 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 04/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21628 | (02) | CA |
AH184A | MEDICARE PTAN (01) | FL |