Provider Demographics
NPI:1619919529
Name:LITTLE, LEW A (MD)
Entity Type:Individual
Prefix:DR
First Name:LEW
Middle Name:A
Last Name:LITTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2103 S MCCALL RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34224-4541
Mailing Address - Country:US
Mailing Address - Phone:941-249-3119
Mailing Address - Fax:941-249-3119
Practice Address - Street 1:2103 S MCCALL RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34224-4541
Practice Address - Country:US
Practice Address - Phone:941-441-9007
Practice Address - Fax:941-249-3119
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME100763207L00000X, 207LA0401X, 2081P2900X, 2083A0300X, 208VP0000X, 225100000X, 208VP0014X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction MedicineGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI22622Medicaid
FL0243461Medicaid