Healthcare Provider Details

I. General information

NPI: 1457926594
Provider Name (Legal Business Name): ALEXANDER LANES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 MILITARY TRL STE 212
JUPITER FL
33458-4817
US

IV. Provider business mailing address

4425 MILITARY TRL STE 212
JUPITER FL
33458-4817
US

V. Phone/Fax

Practice location:
  • Phone: 561-721-1112
  • Fax: 561-296-3082
Mailing address:
  • Phone: 561-721-1112
  • Fax: 561-296-3082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME182094
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: