Individual
SOPHIE M LEWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1774 VERONICA S SHOEMAKER BLVD, FORT MYERS, FL 33916-2255
(239) 851-4685
Mailing address
1774 VERONICA S SHOEMAKER BLVD, FORT MYERS, FL 33916-2255
(239) 851-4685
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
141395300
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141395300
—
FL
Enumeration date
06/04/2013
Last updated
06/04/2013
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