Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | ME114321 | FL |
NPI | 1205153012 |
---|---|
Provider Name | Sara Neely Newman |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2010 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
015757300 | (05) | FL |