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General NPI Number Information
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NPI Number | 1396776522
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Entity Type | Individual
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Provider Name | ANTHONY B LEWIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 01/11/2021
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Provider Practice Location Address
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Address Line | 537 NW LAKE WHITNEY PL UNIT 103-106
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-1620
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Country | US
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Telephone | 772-877-8578
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Fax | 772-398-6246
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Provider Business Mailing Address
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Address Line | 1391 NW SAINT LUCIE WEST BLVD # 216
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34986-2196
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Country | US
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Telephone | 772-877-8578
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Fax | 772-877-8549
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME82977
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License Number State | FL
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