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General NPI Number Information
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NPI Number | 1669232062
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Entity Type | Individual
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Provider Name | LISA LEWIN APRN
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Gender | Female
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Dates
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Enumeration Date | 03/21/2024
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 33123 OIL WELL RD
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City | PUNTA GORDA
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State | FL
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Zip | 33955-9701
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Country | US
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Telephone | 941-833-8118
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Fax |
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Provider Business Mailing Address
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Address Line | 122 SINCLAIR ST SE
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9141
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Country | US
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Telephone | 260-336-3466
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11028917
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License Number State | FL
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