Provider Demographics
NPI:1508104100
Name:LEWIS, MELANIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 W NEWBERRY RD
Mailing Address - Street 2:SUITE A5
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5200
Mailing Address - Country:US
Mailing Address - Phone:352-373-8111
Mailing Address - Fax:
Practice Address - Street 1:4410 W NEWBERRY RD
Practice Address - Street 2:SUITE A5
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5200
Practice Address - Country:US
Practice Address - Phone:352-373-8111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist