Individual
JARED MATHIAS LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
255 DRYDEN CIR, COCOA, FL 32926-2481
(321) 412-0577
(321) 978-9280
Mailing address
255 DRYDEN CIR, COCOA, FL 32926-2481
(321) 412-0577
(321) 978-9280
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CRPS.0101359-P
FL
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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