Provider Demographics
NPI:1790229912
Name:SHOLOMO J LANES MD PA
Entity Type:Organization
Organization Name:SHOLOMO J LANES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SHOLOMO
Authorized Official - Middle Name:J
Authorized Official - Last Name:LANES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-961-1200
Mailing Address - Street 1:3850 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6748
Mailing Address - Country:US
Mailing Address - Phone:954-961-1200
Mailing Address - Fax:954-963-0378
Practice Address - Street 1:3850 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6748
Practice Address - Country:US
Practice Address - Phone:954-961-1200
Practice Address - Fax:954-963-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1057422086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty