Provider Demographics
NPI:1700011640
Name:JOSEPH F LANG MD PL
Entity Type:Organization
Organization Name:JOSEPH F LANG MD PL
Other - Org Name:ISLAND OB/GYN
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-389-5264
Mailing Address - Street 1:PO BOX 2026
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34146-2026
Mailing Address - Country:US
Mailing Address - Phone:239-389-5264
Mailing Address - Fax:239-389-5260
Practice Address - Street 1:983 N COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-2773
Practice Address - Country:US
Practice Address - Phone:239-389-5264
Practice Address - Fax:239-389-5260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77071261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265398200Medicaid
FL51972OtherBCBS OF FLORIDA
FL51972AMedicare PIN
FL51972OtherBCBS OF FLORIDA