Healthcare Provider Details

I. General information

NPI: 1487130118
Provider Name (Legal Business Name): WARNETTE LEWIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 CENTERVIEW DRIVE KNIGHT BUILDING
TALLAHASSEE FL
32399-0001
US

IV. Provider business mailing address

2701 N ROCKY POINT DR STE 650
TAMPA FL
33607-5999
US

V. Phone/Fax

Practice location:
  • Phone: 850-488-1850
  • Fax:
Mailing address:
  • Phone: 800-434-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: