Provider Demographics
NPI:1962522250
Name:LEWEN, GREGORY DAVID (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:DAVID
Last Name:LEWEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20803 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1429
Mailing Address - Country:US
Mailing Address - Phone:305-514-0631
Mailing Address - Fax:305-514-0641
Practice Address - Street 1:20803 BISCAYNE BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1429
Practice Address - Country:US
Practice Address - Phone:305-514-0631
Practice Address - Fax:305-514-0641
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2021-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA063682207W00000X
TXM8124207W00000X
FLME 108618207W00000X
FLME108618207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology