1427068493 NPI number — DR. LEWIS E AUERBACH M.D.

Table of content: DR. LEWIS E AUERBACH M.D. (NPI 1427068493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427068493 NPI number — DR. LEWIS E AUERBACH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AUERBACH
Provider First Name:
LEWIS
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427068493
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1406
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRANDON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33509-1406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-240-6900
Provider Business Mailing Address Fax Number:
813-643-4587

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2111 W. SWANN AVE.
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33606-2478
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-240-6900
Provider Business Practice Location Address Fax Number:
813-643-4587
Provider Enumeration Date:
08/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  ME 47891 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 046777400 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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