Lewis, Mallory Diane
Lewis, Mallory Diane is an individual health care provider with primary practice located at 3754 Highway 90 Ste 300 , Pace FL 32571-1098. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Lewis, Mallory Diane can be contacted via phone (850) 416-5510.Contact Information
Primary practice address
3754 Highway 90 Ste 300
Pace FL 32571-1098
Phone: (850) 416-5510
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | OS17878 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS17878 | Florida |
Profile Details
| NPI number | 1588192520 |
|---|---|
| LBN Legal business name | Lewis, Mallory Diane |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2017 |
| Last updated | Sep 13th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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