Healthcare Provider Details

I. General information

NPI: 1124706205
Provider Name (Legal Business Name): BRONTE ANGELIA ADOREMOS LANTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGI LANTIN

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7503 SURRATTS RD
CLINTON MD
20735-3358
US

IV. Provider business mailing address

7503 SURRATTS RD
CLINTON MD
20735-3358
US

V. Phone/Fax

Practice location:
  • Phone: 301-868-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR270569
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: