Basic Information
| Provider Information | |||||||||
| NPI: | 1316260987 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | URAIRONG RATTANAKORN ARNP INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14001 NW 4TH ST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330282297 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865561422 | ||||||||
| FaxNumber: | 9543919687 | ||||||||
| Practice Location | |||||||||
| Address1: | 7031 SW 62ND AVE | ||||||||
| Address2: | |||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331434701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052847500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2010 | ||||||||
| LastUpdateDate: | 03/10/2010 | ||||||||
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| AuthorizedOfficialLastName: | RATTANAKORN | ||||||||
| AuthorizedOfficialFirstName: | URAIRONG | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7865561422 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | ARNP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.