Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | ME0041816 | FL |
NPI | 1033112263 |
---|---|
Provider Name | Dr. Lane R Carlin |
First Address | Fort Myers, FL 33907-3619 |
Second Address | Fort Myers, FL 33907-3619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 31/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0476397300 | (05) | FL |
A37365 | (02) | FL |