Provider Demographics
NPI:1366939753
Name:LEWIS-NAZARETH, PATRICIA
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:LEWIS-NAZARETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7029
Mailing Address - Country:US
Mailing Address - Phone:954-309-5615
Mailing Address - Fax:
Practice Address - Street 1:950 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7029
Practice Address - Country:US
Practice Address - Phone:954-309-5615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2025-09-25
Deactivation Date:2023-05-17
Deactivation Code:
Reactivation Date:2025-09-25
Provider Licenses
StateLicense IDTaxonomies
FLPS27169183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist