Provider Demographics
NPI:1215395033
Name:LEWIS, SHAMIRA (ARNP)
Entity type:Individual
Prefix:
First Name:SHAMIRA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 TURMAN LOOP
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7794
Mailing Address - Country:US
Mailing Address - Phone:813-402-0238
Mailing Address - Fax:813-907-5559
Practice Address - Street 1:3717 TURMAN LOOP
Practice Address - Street 2:SUITE 101
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7794
Practice Address - Country:US
Practice Address - Phone:813-402-0238
Practice Address - Fax:813-907-5559
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9281172363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016758300Medicaid
FLR2A4KOtherBCBS
FLP01655878OtherRAILROAD MEDICARE
FL016758300Medicaid