Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME0042179 | FL |
NPI | 1033182605 |
---|---|
Provider Name | Dr. Gerardo S. Lanes |
First Address | Coral Springs, FL 33067-4639 |
Second Address | Plantation, FL 33324-2736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 10/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
064267300 | (05) | FL |
D63129 | (02) | FL |