Provider Demographics
NPI:1396074316
Name:DIPLOMAT ORTHOPAEDIC GROUP, P.A.
Entity type:Organization
Organization Name:DIPLOMAT ORTHOPAEDIC GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-533-7474
Mailing Address - Street 1:10600 GRIFFIN ROAD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3208
Mailing Address - Country:US
Mailing Address - Phone:954-533-7474
Mailing Address - Fax:954-533-6437
Practice Address - Street 1:10600 GRIFFIN ROAD
Practice Address - Street 2:SUITE 104
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-3208
Practice Address - Country:US
Practice Address - Phone:954-533-7474
Practice Address - Fax:954-533-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54640207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic TraumaGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10840AMedicare Oscar/Certification