Healthcare Provider Details

I. General information

NPI: 1780681213
Provider Name (Legal Business Name): SANGITA PATEL LEWIS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

394 N SUNCOAST BLVD STE 40
CRYSTAL RIVER FL
34429-5466
US

IV. Provider business mailing address

8455 S SUNCOAST BLVD
HOMOSASSA FL
34446-5066
US

V. Phone/Fax

Practice location:
  • Phone: 352-795-6225
  • Fax: 352-795-6065
Mailing address:
  • Phone: 352-382-0939
  • Fax: 352-382-4297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT2938
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: