Provider Demographics
NPI:1366916843
Name:DR. CAROLYN LANGFORD UROLOGIC SOLUTIONS, LLC
Entity type:Organization
Organization Name:DR. CAROLYN LANGFORD UROLOGIC SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:239-221-0992
Mailing Address - Street 1:9400 GLADIOLUS DR STE 30
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-9615
Mailing Address - Country:US
Mailing Address - Phone:239-221-0992
Mailing Address - Fax:
Practice Address - Street 1:9400 GLADIOLUS DR STE 30
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-9615
Practice Address - Country:US
Practice Address - Phone:239-221-0992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty