MEDICARE: DR. MARY NEWPORT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	ME42473	FL
2	208D00000X	General Practice Physician	ME42473	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063573855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY NEWPORT M.D.

Provider Business Mailing Address
First Line	:	15500 SERENGETI BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34610-7684
Country	:	US
Telephone Number	:	352-428-0251
Fax Number	:	727-379-0015

Provider Business Practice Location Address
First Line	:	15500 SERENGETI BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34610-7684
Country	:	US
Telephone Number	:	352-428-0251
Fax Number	:	727-379-0015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	03/11/2020

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Directions to “ DR. MARY NEWPORT M.D.” Practice Location

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