=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427283209
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN M. NEWMAN, O.D., P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2009
-----------------------------------------------------
Last Update Date | 01/09/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5831 SW 137TH AVE
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33183-1105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-383-4211
-----------------------------------------------------
Fax | 305-383-5065
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10130 SW 2ND ST
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33324-2230
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-599-3285
-----------------------------------------------------
Fax | 305-383-5065
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. STEVEN MARK NEWMAN
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 954-599-3285
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152WC0802X
-----------------------------------------------------
Taxonomy Name | Corneal and Contact Management Optometrist
-----------------------------------------------------
License Number | OPC3029
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 152WP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Optometrist
-----------------------------------------------------
License Number | OPC3029
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OPC3029
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------