Provider Demographics
NPI:1689994964
Name:RANES, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:RANES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:KILLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 LUCERNE TER
Mailing Address - Street 2:2ND FLOOR MP 818
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2014
Mailing Address - Country:US
Mailing Address - Phone:407-841-5297
Mailing Address - Fax:407-481-0182
Practice Address - Street 1:1401 LUCERNE TER
Practice Address - Street 2:2ND FLOOR MP 818
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2014
Practice Address - Country:US
Practice Address - Phone:407-841-5297
Practice Address - Fax:407-481-0182
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME118124207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics