Provider Demographics
NPI:1689906075
Name:ARANGO-LONGO, JENNY (MD)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:ARANGO-LONGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17901 NW 5TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2810
Mailing Address - Country:US
Mailing Address - Phone:954-447-1994
Mailing Address - Fax:
Practice Address - Street 1:17901 NW 5TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-2810
Practice Address - Country:US
Practice Address - Phone:954-447-1994
Practice Address - Fax:954-447-1766
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111550207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007256200Medicaid
FLGW283ZMedicare PIN