Healthcare Provider Details

I. General information

NPI: 1992385876
Provider Name (Legal Business Name): SARAH LANE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 FOREST HILL BLVD
WELLINGTON FL
33414-6103
US

IV. Provider business mailing address

16227 ORCHARD DR
WESTLAKE FL
33470-7044
US

V. Phone/Fax

Practice location:
  • Phone: 352-514-2216
  • Fax:
Mailing address:
  • Phone: 352-514-2216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209035942
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11026321
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: