MEDICARE: ALAN S LANE MD

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	207W00000X	Ophthalmology Physician	ME19364	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972683019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN S LANE MD

Provider Business Mailing Address
First Line	:	4000 HOLLYWOOD BLVD
Second Line	:	SUITE 180N
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6751
Country	:	US
Telephone Number	:	954-963-3336
Fax Number	:	954-963-3341

Provider Business Practice Location Address
First Line	:	4000 HOLLYWOOD BLVD
Second Line	:	SUITE 180N
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6751
Country	:	US
Telephone Number	:	954-963-3336
Fax Number	:	954-963-3341

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	09/04/2013

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Directions to “ ALAN S LANE MD” Practice Location

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