Provider Demographics
NPI:1235184862
Name:SOYLU, LANA L (MD)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:L
Last Name:SOYLU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:L
Other - Last Name:MCCAULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:813-974-2201
Mailing Address - Fax:813-974-2812
Practice Address - Street 1:2 TAMPA GENERAL CIR
Practice Address - Street 2:5TH FLOOR
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3603
Practice Address - Country:US
Practice Address - Phone:813-259-8572
Practice Address - Fax:813-259-8748
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87695208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL268452700Medicaid
FL37347OtherBLUE CROSS BLUE SHIELD
FLH96944Medicare UPIN
FL37347OtherBLUE CROSS BLUE SHIELD