Individual
CLIFFORD TEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13681 DOCTORS WAY, FORT MYERS, FL 33912-4300
(239) 343-1403
(239) 343-4229
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-1403
(239) 343-4229
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9119868
FL
363AS0400X
Surgical Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128470400
—
FL
Enumeration date
09/29/2023
Last updated
11/10/2025
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