Provider Demographics
NPI:1134267297
Name:NEWTON, LISA ANNE (MHS, OTRL)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANNE
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MHS, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5446
Mailing Address - Country:US
Mailing Address - Phone:407-506-6705
Mailing Address - Fax:
Practice Address - Street 1:1757 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5446
Practice Address - Country:US
Practice Address - Phone:407-506-6705
Practice Address - Fax:407-988-1514
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2025-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
FLSA8723235Z00000X
FLOT11227225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL889396900Medicaid