MEDICARE: DR. TODD BRENTLEY LANG OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1141	TN
2	152W00000X	Optometrist	OPC 2288	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410031991	OTHER	FL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	19062	OTHER	FL	BLUE CROSS BLUE SHIELD
3	0341776	OTHER	FL	CIGNA
4	87726	OTHER	FL	UNITEDHEALTHCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	2307923	OTHER	FL	AETNA

General Provider Information

NPI Number	:	1952336794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD BRENTLEY LANG OD

Provider Business Mailing Address
First Line	:	970 KINGS HWY UNIT 2
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33980-4213
Country	:	US
Telephone Number	:	941-637-0202
Fax Number	:	941-637-0425

Provider Business Practice Location Address
First Line	:	970 KINGS HWY UNIT 2
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33980-4213
Country	:	US
Telephone Number	:	941-637-0202
Fax Number	:	941-637-0425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	01/31/2025

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Directions to “ DR. TODD BRENTLEY LANG OD” Practice Location

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