Provider Demographics
NPI:1063517811
Name:NEWCOMER, ANNEMARIE DARTS (OD)
Entity type:Individual
Prefix:DR
First Name:ANNEMARIE
Middle Name:DARTS
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4564 S SUNCOAST BLVD
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34446
Mailing Address - Country:US
Mailing Address - Phone:352-628-3029
Mailing Address - Fax:352-628-6377
Practice Address - Street 1:4564 S SUNCOAST BLVD
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34446
Practice Address - Country:US
Practice Address - Phone:352-628-3029
Practice Address - Fax:352-628-6377
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC2324152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19712OtherBCBS
FL4531770001OtherDME MAC JURISDICTION C
T93060Medicare UPIN
FL4531770001OtherDME MAC JURISDICTION C