Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME98975 | FL |
NPI | 1821017633 |
---|---|
Provider Name | Dominic J Lewis |
First Address | Aventura, FL 33180-1421 |
Second Address | Aventura, FL 33180-1421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 13/04/2015 |