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LEWIS JACKSON DORRANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
4416 NICOLE CIR, TEQUESTA, FL 33469-2574
(561) 603-2788
Mailing address
4416 NICOLE CIR, TEQUESTA, FL 33469-2574

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 2335
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA 2335
STATE LICENCE NUMBER
FL
Enumeration date
10/06/2006
Last updated
06/14/2022
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