THERESA RANDAZZO-BURTON M.D. NPI 1356476741

NPI Information

NPI: 1356476741
Provider Name: THERESA RANDAZZO-BURTON, M.D.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

PECOS Registration: Yes

Address:
807 CHILDRENS WAY
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 697-3600
Get Directions

Theresa Randazzo-burton, M.D. is a child and adolescent psychiatry psychiatry neurology in Jacksonville, FL. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. Theresa Randazzo-burton, M.D. NPI is 1356476741. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

807 CHILDRENS WAY
JACKSONVILLE, FL
ZIP 32207-426
Phone: (904) 697-3600
Fax: (904) 697-3792

The NPI 1356476741 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/23/2007 and was last updated on 5/16/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	218786	MASSACHUSETTS	No
2	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	200701651	NORTH CAROLINA	No
3	2084P0800X	Psychiatry & Neurology	Psychiatry	200701651	NORTH CAROLINA	No
4	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	ME119289	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5910414	MEDICAID	NORTH CAROLINA
2	2022848	MEDICARE PIN	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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