Healthcare Provider Details

I. General information

NPI: 1407597339
Provider Name (Legal Business Name): ALEXIS ELIZABETH NEWBERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXIS ELIZABETH WINANS

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20158 CORTEZ BLVD
BROOKSVILLE FL
34601-3832
US

IV. Provider business mailing address

11170 JENNY WREN RD
WEEKI WACHEE FL
34614-3109
US

V. Phone/Fax

Practice location:
  • Phone: 352-796-0069
  • Fax:
Mailing address:
  • Phone: 727-277-4384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI6821
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: