Active NPI
Monique Cherelle Lewis
- Physical Therapy Assistant
- Brandon, FL
National Provider Identifier
1457042855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA32044
- Practice address
- 702 S Kings Ave
Brandon, FL 33511-5925 - Phone
- (813) 651-1818
- NPI assigned
- May 16, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA32044 | FL | Primary |
Addresses
Primary practice location
702 S Kings Ave
Brandon, FL 33511-5925
Mailing address
11804 Winterset Cove Dr
Riverview, FL 33579-9355
Phone (181) 350-7218
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA32044 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1457042855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11804 WINTERSET COVE DR",
"city": "RIVERVIEW",
"state": "FL",
"postal_code": "335799355",
"telephone_number": "181-350-7218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "702 S KINGS AVE",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115925",
"telephone_number": "813-651-1818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "MONIQUE",
"middle_name": "CHERELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-16",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA32044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.