Provider Demographics
NPI:1255767968
Name:ARANGO, LINA TATIANA (OD)
Entity type:Individual
Prefix:
First Name:LINA
Middle Name:TATIANA
Last Name:ARANGO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7265 NW 173RD DR APT 712
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-8405
Mailing Address - Country:US
Mailing Address - Phone:786-280-5923
Mailing Address - Fax:
Practice Address - Street 1:7265 NW 173RD DR APT 712
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-8405
Practice Address - Country:US
Practice Address - Phone:786-280-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPT 4793152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist