Provider Demographics
NPI:1881938579
Name:LARANGO, RICK ANTHONY
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:ANTHONY
Last Name:LARANGO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7131 ARLINGTON RD
Mailing Address - Street 2:#438
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2903
Mailing Address - Country:US
Mailing Address - Phone:706-955-3001
Mailing Address - Fax:
Practice Address - Street 1:7131 ARLINGTON ROAD
Practice Address - Street 2:#438
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:706-955-3001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN143290390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program