SHELBY A LANE (NPI# 1710230651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710230651 |
| Entity Type | Individual |
| Full Name | SHELBY A LANE |
| Credential | PA-C |
| Practice Address |
3319 Ne 15th Ct Fort Lauderdale FL 33304-1709 |
| Practice Telephone | 9542577859 |
| Practice Fax Number | 9546168063 |
| Mailing Telephone | 9542577859 |
| Mailing Fax Number | 9546168063 |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2019-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA 9106913 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA 9106913 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE ID-TYPE UNSPECIFIED | G9675Z | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3319 Ne 15th Ct, Fort Lauderdale, FL 333041709 | 9542577859 | 9546168063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457814774 | Shelby Avent Lane | Student in an Organized Health Care Education/Training Program | 11234 Anderson St Ste C, Loma Linda, CA 92354-2804 | 2019-04-12 |
| 1245660679 | Shelby Nicole Lane | Social Worker | 807 E Main St, Suite 2-120, Durham, NC 27701-4074 | 2013-11-21 |
| 1912275280 | Shelby A Lane | Physician Assistant | 8450 Northwest Blvd, Indianapolis, IN 46278-1381 | 2011-12-01 |
| Street Address |
3319 NE 15TH CT |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33304-1709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780247189 | Oceanside Elite Surgical Assisting, LLC | Physician Assistant | 3319 Ne 15th Ct, Fort Lauderdale, FL 33304-1709 | 2019-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972128379 | Nurse Practitioner On Demand LLC | Clinic/Center | 1491 N Federal Hwy, Fort Lauderdale, FL 33304 | 2020-06-11 |
| 1053977207 | Hubert Christopher Dauphin | Counselor | 1527 Ne 4 Ave, Ft Lauderdale, FL 33304 | 2019-05-14 |
| 1073176970 | Giant Medical Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1975 E. Sunrise Blvd, Ste 503, Fort Lauderdale, FL 33304 | 2019-04-16 |
| 1790283000 | Genoa Healthcare, LLC | Pharmacy | 919 Ne 13th St Ste 244, Fort Lauderdale, FL 33304 | 2018-02-01 |
| 1063939890 | Suibel Boeras | Dentist | 3000 E Sunrise Blvd, Apt 5d, Fort Lauderdale, FL 33304 | 2017-08-23 |
| 1871023671 | Zahily Quinones Rivero | Technician, Other | 916 N Victoria Park Road, Fort Lauderdale, FL 33304 | 2017-06-14 |
| 1033652847 | A Healthier You Wellness Center, Inc. | Reflexologist | 1960 Ne 47th Street, Unit 102, Fort Lauderdale, FL 33304 | 2016-11-28 |
| 1871975995 | Sahyma Pampin | Physician Assistant | 2414 E. Sunrise Blvd., Ste. 2140a, Ft. Lauderdale, FL 33304 | 2015-06-25 |
| 1881090660 | Tara Zuckerman | Psychologist | 1501 Ne 4th Avenue, Fort Lauderdale, FL 33304 | 2014-11-06 |
| 1053721027 | Felice D. Fusca | Social Worker | 1208 Ne 17 Av, Fort Lauderdale, FL 33304 | 2014-04-30 |
| Find all providers in zip 33304 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154885010 | Chelsea Sophia Zaccario | Physician Assistant | 1625 Se 3rd Ave # 300, Fort Lauderdale, FL 33316-2521 | 2019-01-24 |
| 1598272726 | Elizabeth Vukelich Austin | Physician Assistant | 1625 Se 3rd Ave # 723, Fort Lauderdale, FL 33316-2521 | 2018-01-09 |
| 1265805386 | Sandra Lynn Freymuth | Physician Assistant | 6211 Nw 34th Ave, Fort Lauderdale, FL 33309-1602 | 2015-11-11 |
| 1073526513 | Toribio Castillo | Physician Assistant | 6550 North Federal Highway, Ste 512, Fort Lauderdale, FL 33308-1417 | 2006-08-14 |
| 1023017704 | Kathy Ann Zimmer | Physician Assistant | 6550 N Federal Hwy, Suite 512, Fort Lauderdale, FL 33308-1404 | 2005-07-15 |
| 1780247189 | Oceanside Elite Surgical Assisting, LLC | Physician Assistant | 3319 Ne 15th Ct, Fort Lauderdale, FL 33304-1709 | 2019-04-21 |
| 1306321781 | Marissa Ziegler | Physician Assistant | 1995 E Oakland Park Blvd Ste 250, Fort Lauderdale, FL 33306-1149 | 2018-10-01 |
| 1205327749 | Priscila Marie Gamiotea | Physician Assistant | 3000 Bayview Dr, Fort Lauderdale, FL 33306-1772 | 2018-05-21 |
| 1518466333 | Andrew Michael Walters | Physician Assistant | 1995 E Oakland Park Blvd Ste 250, Fort Lauderdale, FL 33306-1149 | 2018-02-07 |
| 1235589334 | Dock and Roll LLC | Physician Assistant | 6211 Nw 34th Ave, Fort Lauderdale, FL 33309-1602 | 2016-06-20 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33304 |
Please comment or provide details below to improve the information on SHELBY A LANE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.