Healthcare Provider Details

I. General information

NPI: 1053471102
Provider Name (Legal Business Name): JUERGEN LANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91500 OVERSEAS HWY BAPTIST HEALTH MARINERS HOSPITAL
TAVERNIER FL
33070
US

IV. Provider business mailing address

91500 OVERSEAS HWY
TAVERNIER FL
33070-2547
US

V. Phone/Fax

Practice location:
  • Phone: 305-434-3000
  • Fax:
Mailing address:
  • Phone: 305-434-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD00030715
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberME164763
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: