Provider Demographics
NPI:1861851552
Name:HEWITT, TSAHAI (NP-C)
Entity Type:Individual
Prefix:
First Name:TSAHAI
Middle Name:
Last Name:HEWITT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N LAKE DESTINY RD
Mailing Address - Street 2:STE 300
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1101 N LAKE DESTINY RD
Practice Address - Street 2:STE 300
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7114
Practice Address - Country:US
Practice Address - Phone:407-900-0390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9267985363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health