Provider Demographics
NPI:1619152212
Name:LANGENTHAL, STUART F (EDD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:F
Last Name:LANGENTHAL
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 W MCNAB RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-5300
Mailing Address - Country:US
Mailing Address - Phone:954-721-5144
Mailing Address - Fax:954-726-1433
Practice Address - Street 1:7300 W MCNAB RD
Practice Address - Street 2:SUITE 212
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-5300
Practice Address - Country:US
Practice Address - Phone:954-721-5144
Practice Address - Fax:954-726-1433
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS004103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ 0915OtherBLUE CROSS/BLUE SHIELD