Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | ME 91763 | FL |
Y | 208200000X | Surgeon | ME91763 | FL |
Y | 208600000X | Surgeon | ME91763 | FL |
NPI | 1053366229 |
---|---|
Provider Name | Dr. Gordon W Mcneal |
First Address | Tampa, FL 33622-1686 |
Second Address | Tampa, FL 33626-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B45530 | (02) |