Provider Demographics
NPI:1508136961
Name:GREGORY D. LEWEN, M.D., P.L.L.C.
Entity Type:Organization
Organization Name:GREGORY D. LEWEN, M.D., P.L.L.C.
Other - Org Name:LEWEN COSMETIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-900-7099
Mailing Address - Street 1:20803 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1429
Mailing Address - Country:US
Mailing Address - Phone:305-514-0631
Mailing Address - Fax:305-514-0641
Practice Address - Street 1:20803 BISCAYNE BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1429
Practice Address - Country:US
Practice Address - Phone:305-514-0631
Practice Address - Fax:305-514-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108618207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive SurgeryGroup - Single Specialty