Provider Demographics
NPI:1558893420
Name:LEWIS, KRISTYN (MD)
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTYN
Other - Middle Name:
Other - Last Name:SCHEFFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10475 CENTURION PARKWAY NORTH
Mailing Address - Street 2:CENTERONE BUILDING, SUITE 201
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10475 CENTURION PARKWAY NORTH
Practice Address - Street 2:CENTERONE BUILDING, SUITE 201
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256
Practice Address - Country:US
Practice Address - Phone:904-427-8965
Practice Address - Fax:904-427-7337
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME137352207R00000X
FLTRN25356207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine