Provider Demographics
NPI:1184668287
Name:FLINT, LEWIS MATTHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:MATTHEW
Last Name:FLINT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 W AZEELE ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3824
Mailing Address - Country:US
Mailing Address - Phone:813-289-6162
Mailing Address - Fax:813-289-0113
Practice Address - Street 1:2 COLUMBIA DR
Practice Address - Street 2:SUITE G417
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3508
Practice Address - Country:US
Practice Address - Phone:813-844-7968
Practice Address - Fax:813-844-4049
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0077597208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0077597OtherMEDICAL LICENSE
FL0077597OtherMEDICAL LICENSE
FLD01440Medicare UPIN