Healthcare Provider Details

I. General information

NPI: 1326861709
Provider Name (Legal Business Name): BRIANNA LANGFORD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 SE 16TH PL
CAPE CORAL FL
33990-4703
US

IV. Provider business mailing address

7379 WATER DANCE WAY
LAKE WORTH FL
33467-7229
US

V. Phone/Fax

Practice location:
  • Phone: 239-458-1131
  • Fax: 239-458-7789
Mailing address:
  • Phone: 516-670-6827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberPA9122048
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: