MEDICARE: DOUGLAS A NEWLAND MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	ME0034436	FL

General Provider Information

NPI Number	:	1134407737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS A NEWLAND MD PA

Provider Business Mailing Address
First Line	:	2780 CLEVELAND AVE STE 810
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-5817
Country	:	US
Telephone Number	:	239-337-0337
Fax Number	:	239-337-7622

Provider Business Practice Location Address
First Line	:	2780 CLEVELAND AVE STE 810
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-5817
Country	:	US
Telephone Number	:	239-337-0337
Fax Number	:	239-337-7622

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DOUGLAS ALAN NEWLAND
Credential	:	MD
Telephone Number	:	239-337-0337

Provider Enumeration Date	:	07/30/2011
Last Update Date	:	07/30/2011

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