Provider Demographics
NPI:1093824856
Name:NEWMAN, JOHANNA (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JOHANNA
Other - Middle Name:
Other - Last Name:COLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:291 S HALL LN
Mailing Address - Street 2:ORLANDO ANESTHESIA CONSULTANTS, P.A.
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7274
Mailing Address - Country:US
Mailing Address - Phone:407-667-0444
Mailing Address - Fax:407-667-4338
Practice Address - Street 1:10920 BAYMEADOWS RD
Practice Address - Street 2:27-222
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4570
Practice Address - Country:US
Practice Address - Phone:407-667-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9226091367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306866800Medicaid