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Contact Information

LESLEY A RANDOLL, APRN
391 N MAIN ST
KISSIMMEE, FL34744-5271
 Phone: 407-518-1074
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gerontology

363LG0600X 50 Nurse Practitioner
 

Adult Health

364SA2200X 89 Certified Clinical Nurse Specialist
 

Gerontology

364SG0600X 89 Certified Clinical Nurse Specialist
 

Obstetrics & Gynecology

363LX0001X 50 Nurse Practitioner
 

Primary Care

363LP2300X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for LESLEY A RANDOLL · (Female)

NPI # 1104240035
Status Active
Credentials APRN (Advanced Practice Registered Nurse)
Entity Individual
Enumeration date 02/12/2014
Last updated 04/28/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • FL License # APRN11002450
  • MO License # 2014003661
  • FL Other APRN11002450 BOARD OF NURSING LICENSE
  • MO Other 2014003661 BOARD OF NURSING LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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