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General NPI Number Information
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NPI Number | 1043469711
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Entity Type | Individual
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Provider Name | MARJORIE EVANGELINE LEWIS A.R.N.P
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Gender | Female
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 1711 SW 99TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33025-1809
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Country | US
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Telephone | 954-438-4311
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Fax | 954-239-5767
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Provider Business Mailing Address
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Address Line | 1711 SW 99TH AVE
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City | MIRAMAR
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State | FL
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Zip | 33025-1809
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Country | US
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Telephone | 954-438-4311
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Fax | 954-239-5767
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | ARNP 3006442
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP 3006442
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License Number State | FL
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