Provider Demographics
NPI:1316227903
Name:NEWELL, ALBERT MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:MICHAEL
Last Name:NEWELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 S RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:FL
Mailing Address - Zip Code:32141-5903
Mailing Address - Country:US
Mailing Address - Phone:386-427-5208
Mailing Address - Fax:386-427-9840
Practice Address - Street 1:3010 S RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:FL
Practice Address - Zip Code:32141-5903
Practice Address - Country:US
Practice Address - Phone:386-427-5208
Practice Address - Fax:386-427-9840
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist