Healthcare Provider Details

I. General information

NPI: 1467306019
Provider Name (Legal Business Name): NATALIA LEWIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SOUTHPARK BLVD STE 201
ST AUGUSTINE FL
32086-3129
US

IV. Provider business mailing address

3901 UNIVERSITY BLVD S
JACKSONVILLE FL
32216-4312
US

V. Phone/Fax

Practice location:
  • Phone: 904-417-6236
  • Fax:
Mailing address:
  • Phone: 904-345-7251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT26920
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: