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General NPI Number Information
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NPI Number | 1861741795
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Entity Type | Individual
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Provider Name | PERRY DEAN LEWIS ARNP
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Gender | Male
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 08/07/2017
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Provider Practice Location Address
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Address Line | 401 PALMETTO ST
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City | NEW SMYRNA
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State | FL
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Zip | 32168-7322
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Country | US
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Telephone | 386-562-8718
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Fax |
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Provider Business Mailing Address
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Address Line | 6 CARRY CT
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City | PALM COAST
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State | FL
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Zip | 32137-8147
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Country | US
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Telephone | 386-562-8718
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ARNP9166463
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | ARNP9166463
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License Number State | FL
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