Provider Demographics
NPI:1891350047
Name:RAPANUT, MICHELLE ANN MARIE AQUINO
Entity Type:Individual
Prefix:
First Name:MICHELLE ANN MARIE
Middle Name:AQUINO
Last Name:RAPANUT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MICHELLE ANN MARIE
Other - Middle Name:ARENAS
Other - Last Name:AQUINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 45TH ST
Mailing Address - Street 2:
Mailing Address - City:MANGONIA PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2413
Mailing Address - Country:US
Mailing Address - Phone:561-844-6300
Mailing Address - Fax:
Practice Address - Street 1:901 45TH ST
Practice Address - Street 2:
Practice Address - City:MANGONIA PARK
Practice Address - State:FL
Practice Address - Zip Code:33407-2413
Practice Address - Country:US
Practice Address - Phone:561-844-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTN45987246QM0706X
FL244255246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical TechnologistGroup - Single Specialty