Provider Demographics
NPI:1518929116
Name:NEWMAN, DZI-LONG (PA C)
Entity Type:Individual
Prefix:
First Name:DZI-LONG
Middle Name:
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 W GORE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1114
Mailing Address - Country:US
Mailing Address - Phone:407-481-9505
Mailing Address - Fax:407-481-9506
Practice Address - Street 1:80 W GORE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1114
Practice Address - Country:US
Practice Address - Phone:407-481-9505
Practice Address - Fax:407-481-9506
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103405207N00000X
FL9104105363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2754785Medicare ID - Type Unspecified
P37797Medicare UPIN