Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME86997 | FL |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME86997 | FL |
NPI | 1770594202 |
---|---|
Provider Name | Dr. Kevin M. Neal |
First Address | Rockland, DE 19732-0191 |
Second Address | Jacksonville, FL 32207-8426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 22/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
189746312A | (05) | GA |
266546800 | (05) | FL |
H81074 | (02) |