Healthcare Provider Details

I. General information

NPI: 1558463000
Provider Name (Legal Business Name): DEBORAH COMBS LEWIS BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 W MIDWAY RD
FORT PIERCE FL
34981-4823
US

IV. Provider business mailing address

7320 SE HOBE TER
HOBE SOUND FL
33455-6124
US

V. Phone/Fax

Practice location:
  • Phone: 772-468-5600
  • Fax:
Mailing address:
  • Phone: 772-546-2432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: