Provider Demographics
NPI:1619959863
Name:ZIEGLER, LANE D (DO)
Entity Type:Individual
Prefix:
First Name:LANE
Middle Name:D
Last Name:ZIEGLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-278-3350
Practice Address - Street 1:8787 BRYAN DAIRY RD STE 210
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1253
Practice Address - Country:US
Practice Address - Phone:727-397-9641
Practice Address - Fax:727-393-4194
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6045207RH0000X, 207RX0202X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
80488OtherBLUE CROSS / BLUE SHIELD
FL053825600Medicaid
E52394Medicare UPIN
FL80488XMedicare PIN
80488OtherBLUE CROSS / BLUE SHIELD
FL1168350001Medicare NSC