Basic Information
| Provider Information | |||||||||
| NPI: | 1821317256 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEVEN M NEWMAN OD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 771 S STATE ROAD 7 | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333174000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545843838 | ||||||||
| FaxNumber: | 9545835011 | ||||||||
| Practice Location | |||||||||
| Address1: | 771 S STATE ROAD 7 | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333174000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545843838 | ||||||||
| FaxNumber: | 9545835011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2010 | ||||||||
| LastUpdateDate: | 05/25/2010 | ||||||||
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| AuthorizedOfficialLastName: | NEWMAN | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | MARK | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9545993285 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | OD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | OPC0003029 | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 620278100 | 05 | FL | MEDICAID |