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General NPI Number Information
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NPI Number | 1538367131
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Entity Type | Organization
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Legal Business Name | NEWCOMER EYECARE II, P.A.
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 3636 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3513
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Country | US
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Telephone | 352-746-0800
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Fax | 352-527-1358
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Provider Business Mailing Address
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Address Line | 3636 N LECANTO HWY
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City | BEVERLY HILLS
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State | FL
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Zip | 34465-3513
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Country | US
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Telephone | 352-746-0800
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Fax | 352-527-1358
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | DR. JAY D. NEWCOMER
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Credential | O.D.
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Telephone | 352-746-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2301
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License Number State | FL
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