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General NPI Number Information
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NPI Number | 1518335488
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Entity Type | Individual
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Provider Name | WILLIAM LEWIS DR
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Gender | Male
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 841 PRUDENTIAL DR 12TH FLOOR
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8329
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Country | US
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Telephone | 904-217-6838
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Fax |
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Provider Business Mailing Address
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Address Line | 841 PRUDENTIAL DR 12TH FLOOR
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City | JACKSONVILLE
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State | FL
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Zip | 32207-8329
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Country | US
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Telephone |
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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