MEDICARE: MR. RAYMOND ENRIQUE HEWITT II II MS, LMFT

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1811312499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAYMOND ENRIQUE HEWITT II II MS, LMFT

Provider Business Mailing Address
First Line	:	5501 W WATERS AVE
Second Line	:	SUITE 406
City	:	TAMPA
State	:	FL
Zip	:	33634-1229
Country	:	US
Telephone Number	:	813-881-1000
Fax Number	:	813-881-0003

Provider Business Practice Location Address
First Line	:	5501 W WATERS AVE
Second Line	:	SUITE 406
City	:	TAMPA
State	:	FL
Zip	:	33634-1229
Country	:	US
Telephone Number	:	813-881-1000
Fax Number	:	813-881-0003

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

Provider Enumeration Date	:	02/19/2014
Last Update Date	:	07/30/2015

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