Individual
CONNOR LEWELLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7243 DELLA DR FL 3, ORLANDO, FL 32819-5104
(321) 843-5851
(321) 842-0089
Mailing address
7243 DELLA DR, ORLANDO, FL 32819-5104
(321) 842-5851
(321) 842-0089
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9117576
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/07/2023
Last updated
02/05/2024
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