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Deactivated NPI 1598753717 Deactivated / Inactive NPI Male Practitioner

Dr. Henry Walter Randle , MD

Dermatology • Jacksonville, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Henry Randle has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 11, 2005
NPI Deactivation Date December 05, 2019
Total Practice Duration ~14 Years of Practice (2005 – 2019)

Professional Overview & Biography Verified Profile Summary

Dr. Henry Randle, MD was a registered Dermatology practicing in Jacksonville, FL. Throughout an active medical career spanning 14 years, Dr. Randle provided care at the practice location at 4500 SAN PABLO RD S until profile deactivation on 2019-12-05.

Practice Location & Contact Primary Location

Practice Address

4500 San Pablo Rd S

Jacksonville, FL 322241865

Telephone 9049532000
Associated Practice Facility / Clinic
🏢 Mayo Clinic Jacksonville Facility NPI 1790772317

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 21.4 Yrs
State Avg: 23.7 Yrs
Regional Practice Density
59 Specialists

Practicing in Jacksonville, FL (1273 Statewide)

Telehealth Adoption Rate
8.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License FL ME77094

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Katherine Walsh , PA-C, MPH

Physician Assistant

NPI 1003015280

Physician Assistant (Certified), Master of Public Health

Dr. Jami Kinnucan , MD

Internal Medicine - Gastroenterology

NPI 1003045634

Doctor of Medicine (M.D.)

Dr. Glenn Shi , MD

Orthopaedic Surgery

NPI 1003058660

Doctor of Medicine (M.D.)

Dr. Michelle Tulang , MD

Internal Medicine

NPI 1003073586

Doctor of Medicine (M.D.)

NPI 1003100520

Doctor of Medicine (M.D.)

Crystal Lynn , CRNA

Nurse Anesthetist, Certified Registered

NPI 1003148768

Certified Registered Nurse Anesthetist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 05, 2019

Record deactivated on December 05, 2019

NPI Profile Active December 14, 2012

NPI status registered as active in NPPES database

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Updated Practice Location December 14, 2012

Registered at 4500 SAN PABLO RD S, JACKSONVILLE, FL 322241865 (Tel: 9049532000)

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Updated Business Mailing Address December 14, 2012

Registered at 4500 SAN PABLO RD S, JACKSONVILLE, FL 322241865 (Tel: 9049532000)

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Provider Name / Credentials Updated December 14, 2012

Recorded as HENRY RANDLE, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 14, 2012

Dermatology (License #ME77094 in FL)

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Initial NPI Registration & Enumeration October 11, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1598753717
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 11, 2005
Last Update: December 14, 2012
Deactivation Date: December 05, 2019

Mailing Address

4500 San Pablo Rd S

Jacksonville, FL 322241865

Phone: 9049532000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.