Individual
ERONGELA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CVS DR, WOONSOCKET, RI 02895-6146
(800) 746-7287
Mailing address
13620 SE 55TH AVE, SUMMERFIELD, FL 34491-2431
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9552079
FL
Other
Enumeration date
12/31/2020
Last updated
12/31/2020
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