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NPI Code Detail

MEDICARE: PETER ADOLPHUS LEWIS MD

MEDICARE: PETER ADOLPHUS LEWIS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME82915FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
213562XOTHERFLMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
113562OTHERFLBLUE CROSS BLUE SHIELD
30000218136505OTHERFLUNITED HEALTHCARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366451221
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER ADOLPHUS LEWIS MD
Provider Business Mailing Address
First Line : 6416 OLD WINTER GARDEN RD
Second Line :
City : ORLANDO
State : FL
Zip : 32835-1348
Country : US
Telephone Number : 407-751-7288
Fax Number : 407-770-0661
Provider Business Practice Location Address
First Line : 5554 CLARCONA OCOEE RD
Second Line :
City : ORLANDO
State : FL
Zip : 32810-4056
Country : US
Telephone Number : 407-292-0292
Fax Number : 407-292-5175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 06/28/2019

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Directions to “ PETER ADOLPHUS LEWIS MD” Practice Location

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