Individual
HEIDI LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6311 S POINTE BLVD, FORT MYERS, FL 33919-4901
(239) 938-3565
Mailing address
2335 MEADOW HAVEN ST, HUNTINGTON, WV 25704-9483
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME17869
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020009700
—
FL
01
—
P9XDQ
BC BS OF FLORIDA
FL
Enumeration date
03/31/2011
Last updated
01/17/2018
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