Healthcare Provider Details

I. General information

NPI: 1891630471
Provider Name (Legal Business Name): ELEVATE MEN'S HEALTH 365
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 EDGEWATER DR
ORLANDO FL
32804-6350
US

IV. Provider business mailing address

1317 EDGEWATER DR
ORLANDO FL
32804-6350
US

V. Phone/Fax

Practice location:
  • Phone: 407-612-2548
  • Fax: 407-887-5723
Mailing address:
  • Phone: 407-612-2548
  • Fax: 407-887-5723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT ROBERT MCNEILL
Title or Position: FOUNDER AND CEO
Credential: DNP
Phone: 407-580-6913