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Randall
Randall
Braddom
Owner/physician
Medical doctor
Lady Lake,
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Reveal information
Florida Health Care Practitioner Data Portal
Full name
RANDALL BRADDOM
Job Title
Medical Doctor
Location
The Villages, FL, USA
LIC ID
120786
Current License Expiration Date
31/01/2025
Original Date
19/09/2014
Professional Rank Code
ME
Effective Date
19/09/2014
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
SUMTER
Practice Location Address Line 1
1451 El Camino Real
Practice Location Address Line 2
1801 MARKET ST
Practice Location Address City
THE VILLAGES
Practice Location Address State
FL
Practice Location Address Zipcode
32159
Prescribing Indicator
N
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