Healthcare Provider Details

I. General information

NPI: 1861694887
Provider Name (Legal Business Name): AMBER HAMID LANGSHAW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE MCCD 3005A
MIAMI FL
33136-1005
US

IV. Provider business mailing address

17559 SW 54TH STREET
MIRAMAR FL
33029
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6426
  • Fax: 305-243-2617
Mailing address:
  • Phone: 954-885-8635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberME87121
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: