Male or Other

Randy Banks PA-C

Physician Assistant in Gulf Breeze, FL(View on Map)

Full Name

Randy Banks PA-C

NPI Number

1144248824

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/18/2006

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA 3145

Contact
Information

Purpose

Mailing
Location

Address

801 YORK ST
1200 GULF BREEZE PKWY STE A

City

Manitowoc
Gulf Breeze

State

WI
FL

Postal Code

54220-4630
32561-4851

Country

US
US

Telephone Number

(920) 663-9008
(800) 243-7546

Health Information Exchange

Endpoint Type

DIRECT
DIRECT
DIRECT

Endpoint

Randy.Banks@forefrontdermatology.emadirect.md
Randy.Banks@forefrontdermatology.emadirect.md
Randy.Banks@forefrontdermatology.emadirect.md

Endpoint Description

Unknown
Unknown
Unknown

Use

Unknown
Unknown
Unknown

Content Type

Unknown
Unknown
Unknown

Affiliation

N
N
N

Endpoint Location

530 Fontaine StPensacola, FL325032019US
540 Fontaine StPensacola, FL325032019US
1200 Gulf Breeze Pkwy Ste AGulf Breeze, FL325614851US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/05/2022

Provider Address

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