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Individual

SIMON LAINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
5010 HOLLYWOOD BLVD STE 100B, HOLLYWOOD, FL 33021-6557
(954) 967-0028
Mailing address
5010 HOLLYWOOD BLVD STE 100B, HOLLYWOOD, FL 33021-6557
(954) 967-0028

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
ARNP9113024
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP9313024
FL

Other

Enumeration date
10/13/2014
Last updated
08/05/2022
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