=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215029962
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL PAUL NEWMAN DC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2006
-----------------------------------------------------
Last Update Date | 10/15/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9420 SW 77 AVE SUITE 100
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33156-7988
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-666-1402
-----------------------------------------------------
Fax | 305-596-2923
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9420 SW 77 AVE SUITE 100
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33156-7988
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-666-1402
-----------------------------------------------------
Fax | 305-596-2923
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH2818
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------