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NPI Code Detail

MEDICARE: TODD NEWBERG MD PA

MEDICARE: TODD NEWBERG 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
1207R00000XInternal Medicine PhysicianME93532FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11962535666OTHERFLNPI ORGANIZATION

General Provider Information

NPI Number : 1962535666
Entity Type Code : Organization
Provider Name (Legal Business Name) : TODD NEWBERG MD PA
Provider Business Mailing Address
First Line : 5478 LAKE HOWELL RD
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-1036
Country : US
Telephone Number : 407-679-3400
Fax Number : 407-679-3412
Provider Business Practice Location Address
First Line : 5578 LAKE HOWELL RD
Second Line :
City : WINTER PARK
State : FL
Zip : 32792-1036
Country : US
Telephone Number : 407-679-3400
Fax Number : 407-679-3412
Authorized Official
Title or Position : PHYSICIAN
Name : DR. MATTHEW TODD NEWBERG
Credential : M.D.
Telephone Number : 407-679-3400
Provider Enumeration Date : 03/13/2007
Last Update Date : 02/02/2010

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