Provider Demographics
NPI:1275701427
Name:NEWCOMER EYE CARE I P A
Entity Type:Organization
Organization Name:NEWCOMER EYE CARE I P A
Other - Org Name:HOMOSASSA EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNEMARIE
Authorized Official - Middle Name:DARTS
Authorized Official - Last Name:NEWCOMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:352-628-3029
Mailing Address - Street 1:4564 S SUNCOAST BLVD
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446-1103
Mailing Address - Country:US
Mailing Address - Phone:352-628-3029
Mailing Address - Fax:352-628-6377
Practice Address - Street 1:4564 S SUNCOAST BLVD
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34446-1103
Practice Address - Country:US
Practice Address - Phone:352-628-3029
Practice Address - Fax:352-628-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2324152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19712OtherBCBS OF FL
FL4531770001Medicare NSC
FLDN5701Medicare PIN
FLAJ790Medicare PIN