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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

RANDY DAVID WILLIS, DO

Active

RANDY DAVID WILLIS, DO is a Family Medicine healthcare provider located in MT. DORA, Florida. NPI 1689885550 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · MT. DORA, FL

Registration Details

NPI Number
1689885550
Provider Type
Individual
Gender
Male
NPI Issued
May 24, 2007 (19.043735391364 yrs)
Last Updated
Mar 31, 2016
License
OS9622 (FL)

Practice Information

Address
19015 U.S. HIGHWAY 441
MT. DORA, FL, 32757
Browse FL providers · Browse ZIP 32757
Phone
3523836479
Primary Specialty
Family Medicine
207Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.