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Individual

MRS. CASEY WHITE LANGEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2222 S HARBOR CITY BLVD, SUITE 610, MELBOURNE, FL 32901-5594
(321) 723-7716
(321) 723-0604
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 723-7716
(321) 723-0604

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9107661
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010554500
FL
01
OV542
MEDICARE HF
FL
Enumeration date
01/14/2014
Last updated
09/06/2023
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