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NPI Code Detail

MEDICARE: MR. ROGER L NEAL

MEDICARE: MR. ROGER L NEAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist5146FL

General Provider Information

NPI Number : 1437355054
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROGER L NEAL
Provider Business Mailing Address
First Line : 1478 JORDAN HILLS CT
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-2368
Country : US
Telephone Number : 727-461-3896
Fax Number : 727-443-4085
Provider Business Practice Location Address
First Line : 1478 JORDAN HILLS CT
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-2368
Country : US
Telephone Number : 727-461-3896
Fax Number : 727-443-4085
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 12/03/2021

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