Healthcare Provider Details

I. General information

NPI: 1174437727
Provider Name (Legal Business Name): LANGLEY SPECIALTY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7204 MIDWAY TERRACE
OCALA FL
34472
US

IV. Provider business mailing address

1425 S US 301
SUMTERVILLE FL
33585-5141
US

V. Phone/Fax

Practice location:
  • Phone: 352-680-7000
  • Fax:
Mailing address:
  • Phone: 352-793-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. VICKI WYNNS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 352-569-2955