Provider Demographics
NPI:1285961920
Name:NEWMAN, WILLIAM ISAAC (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ISAAC
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 NE CLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32340-5799
Mailing Address - Country:US
Mailing Address - Phone:850-869-0280
Mailing Address - Fax:
Practice Address - Street 1:1312 NE CLOVER AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-5799
Practice Address - Country:US
Practice Address - Phone:850-869-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 017979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist