| Mary Lewis, | |
|
15201 N Cleveland Ave Ste 1010, North Fort Myers, FL 33903-2717 | |
| (855) 674-2500 | |
| (239) 599-4126 |
| Full Name | Mary Lewis |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 15201 N Cleveland Ave Ste 1010, North Fort Myers, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669425732 | NPI | - | NPPES |
| 305829800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | APRN684212 (Florida) | Primary |
| Entity Name | Millennium Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811122880 PECOS PAC ID: 9830244433 Enrollment ID: O20090903000338 |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Lewis, 2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342 Ph: (877) 856-3774 | Mary Lewis, 15201 N Cleveland Ave Ste 1010, North Fort Myers, FL 33903-2717 Ph: (855) 674-2500 |
Jordyn Bodkin, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 83 Pondella Rd, North Fort Myers, FL 33903 Phone: 239-461-6100 | |
Taylor Fitori Marrapese, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13279 N Cleveland Ave, North Fort Myers, FL 33903 Phone: 239-652-4111 | |
Susan M Samerdyke, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13279 N Cleveland Ave, North Fort Myers, FL 33903 Phone: 239-652-4111 Fax: 239-652-4105 | |
Mrs. Editha Anne Butler, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3440 Marinatown Ln Ste 210, North Fort Myers, FL 33903 Phone: 239-230-2000 Fax: 239-235-4640 | |
Omaida D. Borjas, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8750 Henderson Grade, North Fort Myers, FL 33917 Phone: 239-223-0624 | |
Laura Ann Sieben, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3434 Hancock Bridge Pkwy, North Fort Myers, FL 33903 Phone: 877-856-3774 Fax: 239-599-2612 | |
Raisa Diaz Guerrero, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1129 Travis Ave, North Fort Myers, FL 33903 Phone: 239-308-3051 |