LEWIS A. FABRICK, PHD, PA
Social Work at 41 St, Gainesville, FL

License number
Florida SW560
Category
Social Work
Type
Clinical
Owner
Name: DR. LEWIS A. FABRICK PHD
Title: OWNER
Phone: (352) 338-0397
Address
Address
2833 NW 41St St STE 140, Gainesville, FL 32606
National Provider ID: 1508252867
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LEWIS A. FABRICK, PH.D., PA

Gainesville, FL

Registration:
May 29, 1998
Addresses:
2833 NW 41Street #140, Gainesville, FL 32606 (Physical)
2833 NW 41 #140, Gainesville, FL 32606 (Mailing)
2831 NW 41 St, Gainesville, FL 32606
4723 NW 53 Ave, Gainesville, FL 32653
4723 Nw 53 Ave, Gainesville, FL 32653
2833 NW 41 St, Gainesville, FL 32606
State ID:
P98000048881
Business type:
Florida Profit Corporation
Presidents:
Phd Fabrick, 2833 NW 41Street #140, Gainesville, FL 32606 (Physical),Lewis A. Fabrick (President)
Agent:
Lewis Fabrick,2833 NW 41 St #140, Gainesville, FL 32606 (Physical)
EIN:
593514078

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