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General NPI Number Information
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NPI Number | 1750116984
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Entity Type | Organization
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Legal Business Name | LB MEDICAL AND AESTHETICS LLC
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Dates
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Enumeration Date | 09/06/2024
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 3500 E FLETCHER AVE STE 509
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City | TAMPA
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State | FL
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Zip | 33613-4793
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Country | US
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Telephone | 813-946-9846
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Fax | 656-444-7249
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Provider Business Mailing Address
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Address Line | 408 ISLAND RD
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City | TEMPLE TERRACE
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State | FL
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Zip | 33617-6330
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Country | US
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Telephone | 850-672-4012
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LEWIS BARWICK
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Credential | APRN-C
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Telephone | 850-672-4012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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