Individual
LISET RANGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 NW 82ND AVE, DORAL, FL 33126-1011
(786) 420-5924
Mailing address
8888 SW 131ST CT APT 109, MIAMI, FL 33186-1763
(786) 250-8117
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM101979P
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R524-520-72-589-0
—
FL
Enumeration date
06/10/2019
Last updated
06/10/2019
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