Provider Demographics
NPI:1801261599
Name:LANGESFELD, MARINA (IBCLC)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:LANGESFELD
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W PARK DR
Mailing Address - Street 2:APT 10
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3978
Mailing Address - Country:US
Mailing Address - Phone:305-218-8005
Mailing Address - Fax:
Practice Address - Street 1:425 W PARK DR
Practice Address - Street 2:APT 10
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3978
Practice Address - Country:US
Practice Address - Phone:305-218-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-06
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-58476174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN