Basic Information
| Provider Information | |||||||||
| NPI: | 1922403104 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEWIS | ||||||||
| FirstName: | TAMIKA | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4540 CARAMBOLA CIR S | ||||||||
| Address2: | |||||||||
| City: | COCONUT CREEK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330662926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546631035 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1309 N FLAGLER DR | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334013406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618224541 | ||||||||
| FaxNumber: | 5616506093 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2014 | ||||||||
| LastUpdateDate: | 01/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | APRN9223979 | FL | N | Allopathic & Osteopathic Physicians | Hospitalist | 363LA2100X | 9223979 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | 363LA2100X | ARNP9223979 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.