Individual
MARK S LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
37OO WASHINGTON STREET, SUITE 100, HOLLYWOOD, FL 33021-8249
(954) 983-6307
(954) 983-5809
Mailing address
37OO WASHINGTON STREET, SUITE 100, HOLLYWOOD, FL 33021-8249
(954) 983-6307
(954) 983-5809
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME61959
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370555200
—
FL
Enumeration date
04/27/2006
Last updated
06/28/2010
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