Provider Demographics
NPI:1346217635
Name:NEWFIELD, KEVIN B (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:B
Last Name:NEWFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 COCO PLUM DR
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-4016
Mailing Address - Country:US
Mailing Address - Phone:561-741-1700
Mailing Address - Fax:
Practice Address - Street 1:103 COCO PLUM DR
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-4016
Practice Address - Country:US
Practice Address - Phone:561-741-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-05
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 0007356207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253185200Medicaid
FL56765OtherBLUE CROSS BLUE SHIELD
FLG61115Medicare UPIN
FL1231350001Medicare NSC
FLE0063AMedicare PIN
FLE0063BMedicare PIN