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General NPI Number Information
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NPI Number | 1275172892
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Entity Type | Organization
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Legal Business Name | LEWIS FAMILY PSYCHIATRY, LLC
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Dates
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Enumeration Date | 12/30/2019
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Last Update Date | 12/30/2019
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Provider Practice Location Address
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Address Line | 12200 FOREST HILL BLVD
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City | WELLINGTON
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State | FL
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Zip | 33414-5795
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Country | US
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Telephone | 561-303-0433
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Fax | 561-303-0433
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Provider Business Mailing Address
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Address Line | 2646 DANFORTH TER
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City | WELLINGTON
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State | FL
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Zip | 33414-3433
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Country | US
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Telephone | 561-303-0433
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Fax | 561-303-0433
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Authorized Official
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Title or Position | PROVIDER OWNER
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Name | SARA ANN LEWIS
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Credential | APRN
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Telephone | 561-303-0433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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