Provider Demographics
NPI:1407970908
Name:LEWKOWITZ, STUART (DPM)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:
Last Name:LEWKOWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 NE 195TH ST
Mailing Address - Street 2:#318
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179
Mailing Address - Country:US
Mailing Address - Phone:954-558-4084
Mailing Address - Fax:
Practice Address - Street 1:665 NE 195TH ST
Practice Address - Street 2:#318
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-3339
Practice Address - Country:US
Practice Address - Phone:954-558-4084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0001952213EP1101X
NYN003416213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY732605Medicaid
T51087Medicare UPIN
NY732605Medicaid
FL65318Medicare ID - Type Unspecified