Individual
DR. JASON WILLIAM LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
871 W OAKLAND PARK BLVD, WILTON MANORS, FL 33311-1731
(954) 567-7141
(305) 428-8388
Mailing address
1610 VICTORIA POINTE LN, WESTON, FL 33327-1312
(202) 297-2525
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME88332
FL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
ME88332
FL
207RI0200X
Infectious Disease Physician
Primary
ME 88332
FL
Other
Enumeration date
03/14/2006
Last updated
12/22/2024
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