1417081357 NPI number — MRS. MARCY BETH NEWMAN AP, DACM, RN, MPH

Table of content: MRS. MARCY BETH NEWMAN AP, DACM, RN, MPH (NPI 1417081357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417081357 NPI number — MRS. MARCY BETH NEWMAN AP, DACM, RN, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWMAN
Provider First Name:
MARCY
Provider Middle Name:
BETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
AP, DACM, RN, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NEWMAN
Provider Other First Name:
MARCY
Provider Other Middle Name:
B
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
AP, DACM, RN, MPH
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1417081357
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 SE 2ND STREET
Provider Second Line Business Mailing Address:
APT. 1030
Provider Business Mailing Address City Name:
FORT LAUDERDALE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-320-9787
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
805 E BROWARD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT LAUDERDALE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33301-2046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-320-9787
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AP3488 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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