Provider Demographics
NPI:1013966530
Name:P KENNETH NEWMAN MD PA
Entity Type:Organization
Organization Name:P KENNETH NEWMAN MD PA
Other - Org Name:CITRUS ANESTHESIA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOCKLIEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-344-5201
Mailing Address - Street 1:PO BOX 2499
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34451-2499
Mailing Address - Country:US
Mailing Address - Phone:352-344-5201
Mailing Address - Fax:352-344-3822
Practice Address - Street 1:131 S CITRUS AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4701
Practice Address - Country:US
Practice Address - Phone:352-344-5201
Practice Address - Fax:352-344-3822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCK1379OtherRAILROAD MEDICARE
FL00025OtherBLUE CROSS
FL00025OtherBLUE CROSS