Lane, Shelby A

Lane, Shelby A is an individual health care provider with primary practice located at 3319 Ne 15Th Ct , Fort Lauderdale FL 33304-1709. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Lane, Shelby A can be contacted via phone (954) 257-7859.

Contact Information

Primary practice address
3319 Ne 15Th Ct Fort Lauderdale FL 33304-1709
Phone: (954) 257-7859
Fax: (954) 616-8063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA 9106913 Florida
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA 9106913 Florida

Profile Details

NPI number 1710230651
LBN Legal business name Lane, Shelby A
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2012
Last updated May 7th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710230651 NPPES
Florida Other G9675Z MEDICARE ID-TYPE UNSPECIFIED

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