Individual
JASON LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5115 N SOCRUM LOOP RD APT 123, LAKELAND, FL 33809-4293
(813) 802-5777
Mailing address
5115 N SOCRUM LOOP RD APT 123, LAKELAND, FL 33809-4293
(813) 802-5777
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/13/2023
Last updated
06/13/2023
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