Provider Demographics
NPI:1386830628
Name:ORLANDO RANGEL MD PA
Entity Type:Organization
Organization Name:ORLANDO RANGEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:SEBASTIAN
Authorized Official - Last Name:RANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-673-8245
Mailing Address - Street 1:4160 N ARMENIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6453
Mailing Address - Country:US
Mailing Address - Phone:813-673-8245
Mailing Address - Fax:813-673-8640
Practice Address - Street 1:4160 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6453
Practice Address - Country:US
Practice Address - Phone:813-673-8245
Practice Address - Fax:813-673-8245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-20
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82760208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260198200Medicaid
FLK7828Medicare PIN
FL260198200Medicaid