Iman Lewis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

34110 Issued in FL

Practice address

661 Randall Roberts Rd
Fort Walton Beach, FL 32547-4943

Phone

(850) 266-4534

NPI assigned

Nov 19, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1053136606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 RANDALL ROBERTS RD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325474943",
            "telephone_number": "850-266-4534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 RANDALL ROBERTS RD",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325474943",
            "telephone_number": "850-266-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "IMAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "34110",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA005280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Herbert Lester, M.D.
• Ana E Leurinda, M.D.
• Leva Neuroscience LLC
• Joseph E Levine, M.D.
• Anna Lewis
• Jennifer Lewis
• Leah Quinn Lewis, AU.D.
• Marie Laura Liberty
• Lifeisbien Therapeutic Services
• Lifestyle Counseling

• Physical Therapy Assistant in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.