Individual
JENNIFER L LANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1425 MALABAR RD NE, PALM BAY, FL 32907-2506
(321) 434-8078
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-8078
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102077
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127996000
—
FL
01
—
TM157
MEDICARE HF
FL
Enumeration date
04/20/2006
Last updated
10/02/2025
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