Provider Demographics
NPI:1275646291
Name:NEWPORT, D. JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:D. JEFFREY
Middle Name:
Last Name:NEWPORT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 NW 14TH ST
Mailing Address - Street 2:SUITE 1446
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2107
Mailing Address - Country:US
Mailing Address - Phone:305-243-6400
Mailing Address - Fax:305-243-8532
Practice Address - Street 1:1120 NW 14TH ST
Practice Address - Street 2:SUITE 1446
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2107
Practice Address - Country:US
Practice Address - Phone:305-243-6400
Practice Address - Fax:305-243-8532
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0431012084P0800X
OH351214242084P0800X
FLME1206242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4758Medicare UPIN