Basic Information
| Provider Information | |||||||||
| NPI: | 1386830628 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORLANDO RANGEL MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4160 N ARMENIA AVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336076453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136738245 | ||||||||
| FaxNumber: | 8136738640 | ||||||||
| Practice Location | |||||||||
| Address1: | 4160 N ARMENIA AVE | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336076453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136738245 | ||||||||
| FaxNumber: | 8136738245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2007 | ||||||||
| LastUpdateDate: | 05/09/2008 | ||||||||
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| AuthorizedOfficialLastName: | RANGEL | ||||||||
| AuthorizedOfficialFirstName: | ORLANDO | ||||||||
| AuthorizedOfficialMiddleName: | SEBASTIAN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8136738245 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | ME82760 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 260198200 | 05 | FL | MEDICAID |