Provider Demographics
NPI:1477884047
Name:NEWFIELD ORTHOPEDICS P.A.
Entity Type:Organization
Organization Name:NEWFIELD ORTHOPEDICS P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-741-1700
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 1:140 JUPITER LAKES BLVD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7180
Practice Address - Country:US
Practice Address - Phone:561-741-1700
Practice Address - Fax:561-741-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7356207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253185200Medicaid
FL253185200Medicaid
FLE0063BMedicare PIN