Healthcare Provider Details

I. General information

NPI: 1992998736
Provider Name (Legal Business Name): ADAM WAYNE LANGLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 MAGUIRE RD
OCOEE FL
34761
US

IV. Provider business mailing address

2940 MAGUIRE RD
OCOEE FL
34761-4751
US

V. Phone/Fax

Practice location:
  • Phone: 407-581-9065
  • Fax: 321-348-5827
Mailing address:
  • Phone: 407-581-9065
  • Fax: 321-348-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME 105078
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: