Individual
JOHN BRAXTON LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1236 JACARANDA BLVD, VENICE, FL 34292
(941) 496-4444
(941) 496-4223
Mailing address
1360 E VENICE AVE, VENICE, FL 34285-9066
(941) 480-2135
(941) 484-2200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1163
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078516400
—
FL
Enumeration date
09/13/2006
Last updated
11/27/2023
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