Provider Demographics
NPI:1437336302
Name:LEWIS, ZOE ANN (MD)
Entity Type:Individual
Prefix:
First Name:ZOE
Middle Name:ANN
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 COLLINS AVE
Mailing Address - Street 2:#2302
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3262
Mailing Address - Country:US
Mailing Address - Phone:305-695-1090
Mailing Address - Fax:305-673-7139
Practice Address - Street 1:655 W 8TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209
Practice Address - Country:US
Practice Address - Phone:615-371-5765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL71989207R00000X, 207RH0002X
MA205285207R00000X, 207RH0002X
CODR.0054590207RH0002X, 207R00000X
IL036166296208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0189391Medicaid
FL001415100Medicaid
MAG06692Medicare UPIN
FLG06692Medicare UPIN
FL001415100Medicaid