Provider Demographics
NPI:1073220075
Name:THOMAS, LEWIN JOSEPH (HHP, HLC2, IMS2, RMT)
Entity Type:Individual
Prefix:
First Name:LEWIN
Middle Name:JOSEPH
Last Name:THOMAS
Suffix:
Gender:M
Credentials:HHP, HLC2, IMS2, RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9416 SW 182ND TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5688
Mailing Address - Country:US
Mailing Address - Phone:305-986-4265
Mailing Address - Fax:
Practice Address - Street 1:9416 SW 182ND TER
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5688
Practice Address - Country:US
Practice Address - Phone:305-986-4265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA98160225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL87-2063533OtherDEPARTMENT OF TREASURY IRS