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NPI Code Detail

MEDICARE: BRIANA LEWIS

MEDICARE: BRIANA LEWIS
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
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942743901
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANA LEWIS
Provider Business Mailing Address
First Line : 175 MIDDLE ST
Second Line : SUITE 1201
City : LAKE MARY
State : FL
Zip : 32746-3625
Country : US
Telephone Number : 866-610-0580
Fax Number :
Provider Business Practice Location Address
First Line : 1128 BEVILLE RD
Second Line :
City : DAYTONA BEACH
State : FL
Zip : 32114-5747
Country : US
Telephone Number : 386-267-3161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2016
Last Update Date : 11/23/2016

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Directions to “ BRIANA LEWIS ” Practice Location

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