Healthcare Provider Details

I. General information

NPI: 1295005395
Provider Name (Legal Business Name): NEAL AGEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 CYPRESS PKWY
KISSIMMEE FL
34759-3302
US

IV. Provider business mailing address

339 CYPRESS PKWY
KISSIMMEE FL
34759-3302
US

V. Phone/Fax

Practice location:
  • Phone: 689-299-0610
  • Fax: 689-299-0611
Mailing address:
  • Phone: 689-299-0610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME160465
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: