Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Iman Lewis, PTA

Individual provider Physical Therapy Assistant · NPI 1053136606

Iman Lewis, PTA is a Physical Therapy Assistant in Fort Walton Beach, Florida. Practices as a sole proprietor. Licensed in Florida and Georgia.

Licensed in
FL, GA
In the registry since
2024
Specialties on file
2
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

661 Randall Roberts Rd
Fort Walton Beach, FL 32547-4943
Phone: (850) 266-4534
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 34110 (FL)
Physical Therapy Assistant Taxonomy 225200000X · Licence PTA005280 (GA)

Record details

NPI number1053136606
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedNovember 19, 2024
Last updated in NPPESOctober 19, 2025
Certification dateOctober 19, 2025
Mailing address661 Randall Roberts Rd, Fort Walton Beach, FL 32547-4943

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