Healthcare Provider Details

I. General information

NPI: 1700015211
Provider Name (Legal Business Name): KRISTI DANA LANGSTON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 S OLD DIXIE HWY
JUPITER FL
33458-7205
US

IV. Provider business mailing address

799 SW TANGLEWOOD TRL
STUART FL
34997-6260
US

V. Phone/Fax

Practice location:
  • Phone: 954-461-0226
  • Fax:
Mailing address:
  • Phone: 954-461-0226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberOS15674
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: