Provider Demographics
NPI:1528860798
Name:ROQUE ARANGO, ELBA MAYLIN
Entity type:Individual
Prefix:
First Name:ELBA
Middle Name:MAYLIN
Last Name:ROQUE ARANGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 W THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4211
Mailing Address - Country:US
Mailing Address - Phone:623-900-5185
Mailing Address - Fax:623-900-5185
Practice Address - Street 1:505 W THOMAS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4211
Practice Address - Country:US
Practice Address - Phone:623-900-5185
Practice Address - Fax:623-900-5185
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty