Healthcare Provider Details
I. General information
NPI: 1447232772
Provider Name (Legal Business Name): JAMES W NEEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/14/2005
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1130 HICKORY ST
MELBOURNE FL
32901-1973
US
IV. Provider business mailing address
3300 S FISKE BLVD
ROCKLEDGE FL
32955-4306
US
V. Phone/Fax
- Phone: 321-361-5598
- Fax: 321-724-4324
- Phone: 321-361-5598
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0000X |
| Taxonomy | Hematology (Internal Medicine) Physician |
| License Number | ME82552 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | ME82552 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RX0202X |
| Taxonomy | Medical Oncology Physician |
| License Number | ME82552 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: