Provider Demographics
NPI:1639141120
Name:LEWIS, STUART T (DO)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:T
Last Name:LEWIS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:13512 CARRICK GREEN CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3647
Mailing Address - Country:US
Mailing Address - Phone:561-364-5600
Mailing Address - Fax:561-364-4010
Practice Address - Street 1:13512 CARRICK GREEN CT
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3647
Practice Address - Country:US
Practice Address - Phone:561-364-5600
Practice Address - Fax:561-364-4010
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2018-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS7340207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH10708Medicare UPIN
FLE3662AMedicare PIN