Mary Alice Bullard Lane

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

688942598 Issued in FL

Practice address

530 Yew CT
Altamonte Springs, FL 32714-1459

Phone

(407) 862-7632

Fax

(407) 862-8739

NPI assigned

Nov 2, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1629378948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160718",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327160718",
            "telephone_number": "407-862-7632",
            "fax_number": "407-862-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 YEW CT",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327141459",
            "telephone_number": "407-862-7632",
            "fax_number": "407-862-8739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLARD LANE",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "688942598",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "688942596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Kathleen Bryskin, M.D.
• Howard S Buchoff, M.D.
• Jodee Sue Buis, LMHC
• Janet Marie Buitron, CST, CSFA
• Cassandra Bukaty, APRN
• Imee Margrethe Cezar Buno, FNP-C
• Claudio Buonfiglio, DMD
• Ampai Burbach
• Tommie L. Burchfield, DMD
• Arnold Diaz Burdeos, RPT

• Community Health Worker in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.