Provider Demographics
NPI:1447240775
Name:LANE, FRANK B (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:B
Last Name:LANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 18372
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-8372
Mailing Address - Country:US
Mailing Address - Phone:813-872-0702
Mailing Address - Fax:813-876-0997
Practice Address - Street 1:2605 W SWANN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4039
Practice Address - Country:US
Practice Address - Phone:813-872-0702
Practice Address - Fax:813-876-0997
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME12971207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053019100Medicaid
830008569OtherRAILROAD MEDICARE
FL29759OtherBCBS
FL29759YMedicare PIN
FLD53708Medicare UPIN
FL053019100Medicaid