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NPI 1326649476

NPI 1326649476 : GINA RANA, MD, PA : PORT ST LUCIE, FL

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General NPI Number Information
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    NPI Number           |    1326649476
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    Entity Type          |    Organization 
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    Legal Business Name  |    GINA RANA, MD, PA 
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Dates
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    Enumeration Date     |    11/05/2020
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    Last Update Date     |    11/05/2020
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Provider Practice Location Address
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    Address Line         |    1715 SE TIFFANY AVE 
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    City                 |    PORT ST LUCIE
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    State                |    FL
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    Zip                  |    34952-7511
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    Country              |    US
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    Telephone            |    561-203-9185
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    Fax                  |    772-335-3937
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Provider Business Mailing Address
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    Address Line         |    1715 SE TIFFANY AVE 
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    City                 |    PORT ST LUCIE
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    State                |    FL
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    Zip                  |    34952-7511
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    Country              |    US
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    Telephone            |    561-203-9185
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    Fax                  |    772-335-3937
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Authorized Official
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    Title or Position    |    PSYCHIATRIST
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    Name                 |    DR. GINA  RANA 
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    Credential           |    MD
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    Telephone            |    561-203-9185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM0850X
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    Taxonomy Name        |    Adult Mental Health Clinic/Center
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    License Number       |    
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    License Number State |    
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