Provider Demographics
NPI:1578569810
Name:LANG, ELLIOT N (MD)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:N
Last Name:LANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11767 S DIXIE HWY
Mailing Address - Street 2:SUITE 357
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4438
Mailing Address - Country:US
Mailing Address - Phone:786-342-8082
Mailing Address - Fax:800-404-0732
Practice Address - Street 1:14201 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-7224
Practice Address - Country:US
Practice Address - Phone:786-342-8082
Practice Address - Fax:800-404-0732
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME36255207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
1578569810OtherMD MEDICARE CHOICE
FL200010269OtherMEDICARE RAILROAD
FL13452OtherALL FLORIDA
160502400OtherOWCP
52550OtherJMH
1003510OtherPHP
12257OtherWELL CARE
FL250451100Medicaid
FL592417574001OtherCHAMPUS
FL7574OtherAV MED
FL95490OtherBCBS
273481OtherONE HEALTH
FL9314OtherVISTA
FL200010269OtherMEDICARE RAILROAD
D63484Medicare UPIN