Healthcare Provider Details

I. General information

NPI: 1467912717
Provider Name (Legal Business Name): CHRISTOPHER O'NEIL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 SW ARCHER RD
GAINESVILLE FL
32608-1134
US

IV. Provider business mailing address

1505 SW ARCHER RD
GAINESVILLE FL
32608-1134
US

V. Phone/Fax

Practice location:
  • Phone: 224-558-1401
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberTRN28567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: