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General NPI Number Information
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NPI Number | 1063573855
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Entity Type | Individual
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Provider Name | MARY NEWPORT M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 15500 SERENGETI BLVD
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City | SPRING HILL
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State | FL
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Zip | 34610-7684
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Country | US
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Telephone | 352-428-0251
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Fax | 727-379-0015
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Provider Business Mailing Address
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Address Line | 15500 SERENGETI BLVD
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City | SPRING HILL
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State | FL
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Zip | 34610-7684
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Country | US
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Telephone | 352-428-0251
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Fax | 727-379-0015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | ME42473
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME42473
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License Number State | FL
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