Provider Demographics
NPI:1609153824
Name:LANGFORD, VERNON MATTHEW (RN, MSN, FNP-C)
Entity Type:Individual
Prefix:MR
First Name:VERNON
Middle Name:MATTHEW
Last Name:LANGFORD
Suffix:
Gender:M
Credentials:RN, MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 CROCUS CT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4519
Mailing Address - Country:US
Mailing Address - Phone:313-522-9468
Mailing Address - Fax:
Practice Address - Street 1:5130 SUNFOREST DR STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6322
Practice Address - Country:US
Practice Address - Phone:657-400-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL247200000X
OHCOA.12625-NP363L00000X
FLARNP9322191363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other