Individual
ANDREA LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
3633 W WATERS AVE, TAMPA, FL 33614-2783
(813) 932-5119
Mailing address
3633 W WATERS AVE, TAMPA, FL 33614-2783
(813) 932-5119
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL5273
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL5273
ATC
FL
Enumeration date
05/17/2019
Last updated
05/17/2019
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