Individual
PERRY DEAN LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
401 PALMETTO ST, NEW SMYRNA, FL 32168-7322
(386) 562-8718
Mailing address
6 CARRY CT, PALM COAST, FL 32137-8147
(386) 562-8718
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
ARNP9166463
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
ARNP9166463
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007395600
—
FL
01
—
HB515
MEDICARE
FL
Enumeration date
09/06/2012
Last updated
08/07/2017
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