Provider Demographics
NPI:1942379466
Name:RANGEL, ORLANDO S (MD PA)
Entity Type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:S
Last Name:RANGEL
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:MR
Other - First Name:ORLANDO
Other - Middle Name:S
Other - Last Name:RANGEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PA
Mailing Address - Street 1:4160 N ARMENIA AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6453
Mailing Address - Country:US
Mailing Address - Phone:813-673-8245
Mailing Address - Fax:813-673-8640
Practice Address - Street 1:4160 N ARMENIA AVE
Practice Address - Street 2:STE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6453
Practice Address - Country:US
Practice Address - Phone:813-673-8245
Practice Address - Fax:813-673-8640
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82760208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260198200Medicaid
FL260198200Medicaid
FLE7818YMedicare PIN