Provider Demographics
NPI:1568611226
Name:LEWIS BRODSKY MD PA
Entity Type:Organization
Organization Name:LEWIS BRODSKY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:239-280-0034
Mailing Address - Street 1:5067 TAMIAMI TRL E
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-4128
Mailing Address - Country:US
Mailing Address - Phone:850-556-7993
Mailing Address - Fax:239-330-7385
Practice Address - Street 1:5067 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-4128
Practice Address - Country:US
Practice Address - Phone:850-556-7993
Practice Address - Fax:239-330-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty