Healthcare Provider Details

I. General information

NPI: 1922684679
Provider Name (Legal Business Name): LAUREN KELSEY RANGEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 E 25TH ST STE 118
HIALEAH FL
33013-3804
US

IV. Provider business mailing address

777 E 25TH ST STE 118
HIALEAH FL
33013-3804
US

V. Phone/Fax

Practice location:
  • Phone: 305-915-5807
  • Fax:
Mailing address:
  • Phone: 305-915-5807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME169033
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: