Provider Demographics
NPI:1235181769
Name:LEWENSON, ROBERT NEIL (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEIL
Last Name:LEWENSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5218 E LONGBOAT BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4232
Mailing Address - Country:US
Mailing Address - Phone:813-855-3767
Mailing Address - Fax:813-880-8375
Practice Address - Street 1:8025 CITRUS PARK TOWN CTR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-3180
Practice Address - Country:US
Practice Address - Phone:813-792-1628
Practice Address - Fax:813-792-8379
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1544152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT54769Medicare UPIN
FL20526AMedicare ID - Type Unspecified