Provider Demographics
NPI:1366094351
Name:A. LEWIS & ASSOCIATES, P.A.
Entity type:Organization
Organization Name:A. LEWIS & ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MODY
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC
Authorized Official - Phone:954-817-4773
Mailing Address - Street 1:3471 N FEDERAL HWY STE 207
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1048
Mailing Address - Country:US
Mailing Address - Phone:954-817-4773
Mailing Address - Fax:
Practice Address - Street 1:3471 N FEDERAL HWY STE 207
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1048
Practice Address - Country:US
Practice Address - Phone:954-817-4773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty