Individual
MR. RAY ALLEN LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTIONER
Contact information
Practice address
818 CHESTNUT ST, CLEARWATER, FL 33756-5642
(727) 477-3636
Mailing address
13 S GRAHAM RD, AVON PARK, FL 33825-8155
(863) 899-8905
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11041872
FL
Other
Enumeration date
08/27/2025
Last updated
08/27/2025
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