Provider Demographics
NPI:1588030324
Name:LEWINSKY, FERNANDA
Entity Type:Individual
Prefix:
First Name:FERNANDA
Middle Name:
Last Name:LEWINSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 HOLLY HEIGHTS DR APT 25
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-4766
Mailing Address - Country:US
Mailing Address - Phone:954-655-5255
Mailing Address - Fax:
Practice Address - Street 1:1455 HOLLY HEIGHTS DR APT 25
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-4766
Practice Address - Country:US
Practice Address - Phone:954-655-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16627101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)