Provider Demographics
NPI:1114037843
Name:RANGEL, NELSON (MSPT, CMT)
Entity Type:Individual
Prefix:MR
First Name:NELSON
Middle Name:
Last Name:RANGEL
Suffix:
Gender:M
Credentials:MSPT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 SW 39TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3030
Mailing Address - Country:US
Mailing Address - Phone:305-508-8114
Mailing Address - Fax:305-226-5648
Practice Address - Street 1:12301 SW 39TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3030
Practice Address - Country:US
Practice Address - Phone:305-508-8114
Practice Address - Fax:305-226-5648
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT21343OtherLICENSE #