Healthcare Provider Details

I. General information

NPI: 1295939072
Provider Name (Legal Business Name): LAUREN CHRISTINE KANE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 5TH ST S
ST PETERSBURG FL
33701-4804
US

IV. Provider business mailing address

601 5TH ST S
ST PETERSBURG FL
33701-4804
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-6666
  • Fax:
Mailing address:
  • Phone: 727-767-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number323858
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA110312
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberM6910
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number290430
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberMD485829
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberME138239
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: