Provider Demographics
NPI:1942333679
Name:LANGE'S ALTERNATIVE MEDICAL PRACTICE P.A.
Entity Type:Organization
Organization Name:LANGE'S ALTERNATIVE MEDICAL PRACTICE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, AP, LMT
Authorized Official - Phone:407-322-4963
Mailing Address - Street 1:3525 W LAKE MARY BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3473
Mailing Address - Country:US
Mailing Address - Phone:407-322-4963
Mailing Address - Fax:407-330-7759
Practice Address - Street 1:3525 W LAKE MARY BLVD
Practice Address - Street 2:STE
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3473
Practice Address - Country:US
Practice Address - Phone:407-322-4963
Practice Address - Fax:407-330-7759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLLMT 21354OtherLIC MASSAGE THERAPIST
FLAP 1631OtherACUPUNCTURE PHYSICIAN