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General NPI Number Information
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NPI Number | 1740242353
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Entity Type | Individual
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Provider Name | PHILLIP GARY NEWCOMM JR. MD
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Gender | Male
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 305 GRANELLO AVE
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City | CORAL GABLES
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State | FL
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Zip | 33146-1806
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Country | US
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Telephone | 305-446-2546
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Fax | 305-448-0219
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Provider Business Mailing Address
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Address Line | 305 GRANELLO AVE
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City | CORAL GABLES
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State | FL
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Zip | 33146-1806
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Country | US
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Telephone | 305-446-2546
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Fax | 305-448-0219
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 56925
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License Number State | FL
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