Provider Demographics
NPI:1770189987
Name:RANGEL-ORELLANOS, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:RANGEL-ORELLANOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4704B W MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-1042
Mailing Address - Country:US
Mailing Address - Phone:813-559-4164
Mailing Address - Fax:
Practice Address - Street 1:4704B W MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33616-1042
Practice Address - Country:US
Practice Address - Phone:813-559-4164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator