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General NPI Number Information
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NPI Number | 1528261302
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Entity Type | Individual
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Provider Name | ILANA MARA NEWMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 3720 EXECUTIVE WAY STE 106
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City | MIRAMAR
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State | FL
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Zip | 33025-3946
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Country | US
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Telephone | 877-868-4827
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Fax | 877-283-0663
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Provider Business Mailing Address
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Address Line | 123 SE 3RD AVE SUITE 460
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City | MIAMI
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State | FL
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Zip | 33131-2003
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Country | US
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Telephone | 877-868-4827
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Fax | 877-283-0663
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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 | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | 205825
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | ME 92320
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 205825
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | ME92320
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License Number State | FL
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