Provider Demographics
NPI:1740395839
Name:NEWMAN, TODD C (PTA)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:C
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:12876 CRISTI WAY
Mailing Address - Street 2:
Mailing Address - City:BOKEELIA
Mailing Address - State:FL
Mailing Address - Zip Code:33922-2615
Mailing Address - Country:US
Mailing Address - Phone:239-283-4849
Mailing Address - Fax:239-542-1802
Practice Address - Street 1:885 SE 47TH TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9079
Practice Address - Country:US
Practice Address - Phone:239-542-0900
Practice Address - Fax:239-542-1802
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA 18134225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant