Individual
ANTWON LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2404 E 17TH AVE, TAMPA, FL 33605-2810
(813) 380-0680
Mailing address
2404 E 17TH AVE, TAMPA, FL 33605-2810
(813) 380-0680
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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