Provider Demographics
NPI:1316260987
Name:URAIRONG RATTANAKORN ARNP INC
Entity type:Organization
Organization Name:URAIRONG RATTANAKORN ARNP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:URAIRONG
Authorized Official - Middle Name:
Authorized Official - Last Name:RATTANAKORN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:786-556-1422
Mailing Address - Street 1:14001 NW 4TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-2297
Mailing Address - Country:US
Mailing Address - Phone:786-556-1422
Mailing Address - Fax:954-391-9687
Practice Address - Street 1:7031 SW 62ND AVE
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4701
Practice Address - Country:US
Practice Address - Phone:305-284-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty