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Organization
LEWIS A. FABRICK, PHD, PA
Active
Organization
LEWIS A. FABRICK, PHD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEWIS A. FABRICK PHD (OWNER)
(352) 338-0397
Entity
Organization
Contact information
Practice address
2833 NW 41ST ST STE 140, GAINESVILLE, FL 32606-6987
(352) 338-0397
(352) 372-6787
Mailing address
2833 NW 41ST ST STE 140, GAINESVILLE, FL 32606-6987
(352) 338-0397
(352) 372-6787
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW560
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z0937
BCBS
FL
01
—
Z0973A
MEDICARE PTAN
FL
Enumeration date
04/13/2015
Last updated
06/03/2015
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