Physician Compare National (NPI:1235423138)

HEALTHCARE PROVIDER: CLONES LANS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1235423138
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5395915565
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150519002537
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LANS
	Individual professional last name
Provider First Name	CLONES
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	16400 NW2ND AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	NORTH MIAMI BEACH
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	331696035
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100022
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JACKSON HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y