Provider Demographics
NPI:1689996134
Name:LEWIN, ADAM B (PHD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:B
Last Name:LEWIN
Suffix:
Gender:M
Credentials:PHD
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 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:813-974-2201
Mailing Address - Fax:813-974-2812
Practice Address - Street 1:800 6TH ST S
Practice Address - Street 2:CHILDRENS HEALTH CTR
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4817
Practice Address - Country:US
Practice Address - Phone:727-767-4150
Practice Address - Fax:727-767-8532
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPY8063103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593CCOtherBLUE CROSS BLUE SHIELD