Provider Demographics
NPI:1326269853
Name:LANGEN, WENDY HOON (PA)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:HOON
Last Name:LANGEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 SW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2613
Mailing Address - Country:US
Mailing Address - Phone:305-586-4356
Mailing Address - Fax:
Practice Address - Street 1:1920 SW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2613
Practice Address - Country:US
Practice Address - Phone:305-586-4356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101521363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP76391Medicare UPIN
FLE8823ZMedicare ID - Type Unspecified