Provider Demographics
NPI:1376749184
Name:KAI-LEWIS, EMMANUEL HAROLD (MD)
Entity Type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:HAROLD
Last Name:KAI-LEWIS
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 1:6091 S POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4899
Mailing Address - Country:US
Mailing Address - Phone:239-985-7171
Mailing Address - Fax:
Practice Address - Street 1:6091 S POINTE BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4899
Practice Address - Country:US
Practice Address - Phone:239-985-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127625207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIP672UMedicare PIN