Healthcare Provider Details

I. General information

NPI: 1275701427
Provider Name (Legal Business Name): NEWCOMER EYE CARE I P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4564 S SUNCOAST BLVD
HOMOSASSA FL
34446-1103
US

IV. Provider business mailing address

4564 S SUNCOAST BLVD
HOMOSASSA FL
34446-1103
US

V. Phone/Fax

Practice location:
  • Phone: 352-628-3029
  • Fax: 352-628-6377
Mailing address:
  • Phone: 352-628-3029
  • Fax: 352-628-6377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC2324
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberOPC2324
License Number StateFL

VIII. Authorized Official

Name: DR. ANNEMARIE DARTS NEWCOMER
Title or Position: PRESIDENT
Credential: OD
Phone: 352-628-3029