Lanham, Fallon

Lanham, Fallon is an individual health care provider with primary practice located at 601 5Th St S Ste 302 , Saint Petersburg FL 33701-4804. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Lanham, Fallon can be contacted via phone (813) 505-2377.

Contact Information

Primary practice address
601 5Th St S Ste 302 Saint Petersburg FL 33701-4804
Phone: (813) 505-2377
Fax: (813) 200-3491
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 9110340 Florida

Profile Details

NPI number 1053847160
LBN Legal business name Lanham, Fallon
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2017
Last updated Sep 9th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053847160 NPPES
Florida MEDICAID 020882500

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