Individual
STEPHANIE LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9290 136TH WAY, SEMINOLE, FL 33776-2303
(172) 745-9881
Mailing address
9290 136TH WAY, SEMINOLE, FL 33776-2303
(172) 745-9881
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
861255231
—
FL
Enumeration date
03/10/2021
Last updated
03/10/2021
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