Provider Demographics
NPI:1275561532
Name:LEWIS, NOELINE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:NOELINE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:BOX 016960 M851
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-6960
Mailing Address - Country:US
Mailing Address - Phone:305-243-4029
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:BOX 016960 M851
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33101-6960
Practice Address - Country:US
Practice Address - Phone:305-243-4029
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1931282163W00000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3058689-00Medicaid
FL3058689-00Medicaid
FLY032VMedicare ID - Type Unspecified