Provider Demographics
NPI:1568425742
Name:LANGFORD, CAROLYN F (DO)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:F
Last Name:LANGFORD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:4571 COLONIAL BLVD
Practice Address - Street 2:
Practice Address - City:FT. MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-5403
Practice Address - Country:US
Practice Address - Phone:239-434-6300
Practice Address - Fax:239-322-5610
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9441208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1193348OtherWELLCARE
FL10M224OtherHEALTHY KIDS
FL272629700Medicaid
FL7854718OtherAETNA PROVIDER #
FL297365OtherAVMED
FL16105OtherBCBS OF FL
FL7489373OtherCIGNA
FLP01193244OtherRAILROAD MCR
FLP300194OtherFREEDOM HEALTH
FL10M224OtherHEALTHY KIDS
FL1193348OtherWELLCARE
FLP01193244OtherRAILROAD MCR