Provider Demographics
NPI:1144281213
Name:LEWIS, JANET K (MD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:K
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:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:2345 BOBCAT VILLAGE CENTER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34288-8999
Practice Address - Country:US
Practice Address - Phone:941-257-2930
Practice Address - Fax:941-257-2923
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME115168208000000X, 207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14Q3MOtherBCBS OF FL
FL008624600Medicaid
FLH0378ZMedicare PIN