Provider Demographics
NPI:1770667164
Name:NEWTON, HERBERT BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:BRUCE
Last Name:NEWTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 286
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4675
Mailing Address - Country:US
Mailing Address - Phone:407-303-2770
Mailing Address - Fax:407-303-3268
Practice Address - Street 1:2501 N ORANGE AVE STE 286
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4675
Practice Address - Country:US
Practice Address - Phone:407-303-2770
Practice Address - Fax:407-303-3268
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350596952084N0400X
FLME1268062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0794798Medicaid
OHNE0667813Medicare PIN
OHH299060Medicare PIN
OH0794798Medicaid