Provider Demographics
NPI:1063893956
Name:RANGEL NAVARRO, ARIEL (APRN)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:RANGEL NAVARRO
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5605 NW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4000
Mailing Address - Country:US
Mailing Address - Phone:305-685-5688
Mailing Address - Fax:786-618-5307
Practice Address - Street 1:20215 NW 2ND AVE STE 1
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-2538
Practice Address - Country:US
Practice Address - Phone:305-685-5688
Practice Address - Fax:305-652-4545
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FL11004884363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No104100000XBehavioral Health & Social Service ProvidersSocial Worker