Provider Demographics
NPI:1477800803
Name:RANTANEN, LLOYD T
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:T
Last Name:RANTANEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 EUBANK BLVD SE
Mailing Address - Street 2:BLDG. 831/832
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-3453
Mailing Address - Country:US
Mailing Address - Phone:505-844-4237
Mailing Address - Fax:
Practice Address - Street 1:1515 EUBANK BLVD SE
Practice Address - Street 2:BLDG. 831/832
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-3453
Practice Address - Country:US
Practice Address - Phone:505-844-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00015312146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic