Provider Demographics
NPI:1750304564
Name:LEWIS, TAMEIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMEIKA
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4237
Mailing Address - Country:US
Mailing Address - Phone:407-900-5930
Mailing Address - Fax:407-930-9243
Practice Address - Street 1:417 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2805
Practice Address - Country:US
Practice Address - Phone:407-900-5930
Practice Address - Fax:407-930-9243
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL29188207V00000X
FLME106307207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002517700Medicaid
148X7OtherFLORIDA BLUE
148X7OtherFLORIDA BLUE