Healthcare Provider Details

I. General information

NPI: 1194741785
Provider Name (Legal Business Name): ALICJA LANGNER MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 10TH ST N
NAPLES FL
34103-3806
US

IV. Provider business mailing address

3425 10TH ST N
NAPLES FL
34103-3806
US

V. Phone/Fax

Practice location:
  • Phone: 239-262-3669
  • Fax:
Mailing address:
  • Phone: 239-262-3669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME 70794
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: