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General NPI Number Information
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NPI Number | 1184970626
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Entity Type | Organization
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Legal Business Name | PREMIER FAMILY & SPORTS MEDICINE, LLC
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 03/27/2019
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Provider Practice Location Address
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Address Line | 2940 MAGUIRE RD STE 200
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City | OCOEE
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State | FL
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Zip | 34761-4751
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Country | US
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Telephone | 407-581-9065
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Fax | 321-348-5827
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Provider Business Mailing Address
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Address Line | 2940 MAGUIRE RD STE 200
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City | OCOEE
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State | FL
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Zip | 34761-4751
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Country | US
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Telephone | 407-581-9065
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Fax | 321-348-5827
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Authorized Official
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Title or Position | CO-OWNER/PHYSICIAN
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Name | DR. ADAM LANGLEY
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Credential | M.D.
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Telephone | 407-581-9065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | ME105459
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME105078
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License Number State | FL
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