Individual
TODD C LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 HEALTH PARK BLVD, SUITE 1006, ST AUGUSTINE, FL 32086-3707
(904) 794-7050
(904) 794-7135
Mailing address
3550 UNIVERSITY BLVD S, SUITE 302, JACKSONVILLE, FL 32216-4267
(904) 733-4444
(904) 733-5377
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
0101236867
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
406745200
—
MD
Enumeration date
06/16/2006
Last updated
01/23/2014
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