Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | ME74378 | FL |
NPI | 1275594475 |
---|---|
Provider Name | Dr. Maha Lewis |
First Address | Clearwater, FL 33761-2013 |
Second Address | Clearwater, FL 33761-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2006 |
Last Update Date | 14/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
254935201 | (05) | FL |
F77604 | (02) | FL |