MEDICARE: EMILY JOANN LEHEW PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	363A00000X	Physician Assistant	PA9116185	FL

General Provider Information

NPI Number	:	1326679333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY JOANN LEHEW PA

Provider Business Mailing Address
First Line	:	202 S PARKER ST UNIT 228
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2393
Country	:	US
Telephone Number	:	919-748-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 S HYDE PARK AVE STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2291
Country	:	US
Telephone Number	:	813-876-3611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2020
Last Update Date	:	12/06/2022

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Directions to “ EMILY JOANN LEHEW PA” Practice Location

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