Provider Demographics
NPI:1053700153
Name:LANE, JULES
Entity type:Individual
Prefix:
First Name:JULES
Middle Name:
Last Name:LANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LANE ENTERPRISES UNITED LLC
Mailing Address - Street 2:16120 N. FLORIDA AVE
Mailing Address - City:LUTZ
Mailing Address - State:US
Mailing Address - Zip Code:33549
Mailing Address - Country:UM
Mailing Address - Phone:813-972-1876
Mailing Address - Fax:813-354-2445
Practice Address - Street 1:16120 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6129
Practice Address - Country:US
Practice Address - Phone:813-972-1876
Practice Address - Fax:813-354-2445
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies