MEDICARE: SHIRKERA LEWIS

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
1	106H00000X	Marriage & Family Therapist	IMT4240	FL

General Provider Information

NPI Number	:	1760341853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRKERA LEWIS

Provider Business Mailing Address
First Line	:	1615 VILLAGE SQUARE BLVD STE 4
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-2770
Country	:	US
Telephone Number	:	850-753-8324
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 VILLAGE SQUARE BLVD STE 4
Second Line	:	SUITE 4
City	:	TALLAHASSEE
State	:	FL
Zip	:	32309-2770
Country	:	US
Telephone Number	:	850-753-8324
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “ SHIRKERA LEWIS ” Practice Location

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