Provider Demographics
NPI:1215940218
Name:LANG-LEWIN, CARLA M (MD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:M
Last Name:LANG-LEWIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 W NEPTUNE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-4931
Mailing Address - Country:US
Mailing Address - Phone:813-287-1447
Mailing Address - Fax:
Practice Address - Street 1:4307 W NEPTUNE ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-4931
Practice Address - Country:US
Practice Address - Phone:813-287-1447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51252174400000X
FLME 51252207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272208900Medicaid
FL272208900Medicaid
FL04596WMedicare ID - Type Unspecified