Healthcare Provider Details

I. General information

NPI: 1780897959
Provider Name (Legal Business Name): CHARLES E NEWMAN JR MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 10/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 W GORE ST
ORLANDO FL
32806-1114
US

IV. Provider business mailing address

80 W GORE ST
ORLANDO FL
32806-1114
US

V. Phone/Fax

Practice location:
  • Phone: 407-481-9505
  • Fax: 407-481-9506
Mailing address:
  • Phone: 407-481-9505
  • Fax: 407-481-9506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES NEWMAN JR.
Title or Position: OWNER
Credential: M.D.
Phone: 407-481-9505