Provider Demographics
NPI:1841614237
Name:ORLANG, MA ANTONIETTA
Entity type:Individual
Prefix:
First Name:MA ANTONIETTA
Middle Name:
Last Name:ORLANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8931 COLONIAL CENTER DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-7809
Mailing Address - Country:US
Mailing Address - Phone:239-343-9512
Mailing Address - Fax:239-343-9561
Practice Address - Street 1:8931 COLONIAL CENTER DR
Practice Address - Street 2:SUITE 302
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7809
Practice Address - Country:US
Practice Address - Phone:239-343-9512
Practice Address - Fax:239-343-9561
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNS9215810163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology