Individual
DENNIS M LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1116 11TH ST SW, LIVE OAK, FL 32064
(386) 362-0820
(386) 362-1817
Mailing address
1116 11TH ST SW, LIVE OAK, FL 32064-3608
(386) 362-0820
(386) 362-1817
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5754A
WY
208600000X
Surgery Physician
Primary
ME56099
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01731293
—
FL
01
—
JK189Z
UPIN
FL
Enumeration date
06/23/2006
Last updated
03/22/2021
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