Healthcare Provider Details

I. General information

NPI: 1093129496
Provider Name (Legal Business Name): DAKOTA LANE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 LAWRENCE EXPY
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

PO BOX 100186
GAINESVILLE FL
32610-0186
US

V. Phone/Fax

Practice location:
  • Phone: 408-851-1000
  • Fax:
Mailing address:
  • Phone: 352-265-5911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberTRN20102
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME132840
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: