Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME60369 | FL |
N | 207XS0117X | Orthopaedic Spine Surgeon | ME60369 | FL |
NPI | 1366430407 |
---|---|
Provider Name | Jeffrey Bruce Neustadt |
First Address | St Petersburg, FL 33701-4629 |
Second Address | St Petersburg, FL 33701-4629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 12/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
054633000 | (05) | FL |
D44317 | (02) | FL |