Healthcare Provider Details

I. General information

NPI: 1093164121
Provider Name (Legal Business Name): JAMES ERIC NEAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 06/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 S ORANGE AVE FL 5
ORLANDO FL
32806-1215
US

IV. Provider business mailing address

1222 S ORANGE AVE FL 5
ORLANDO FL
32806-1215
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-1764
  • Fax:
Mailing address:
  • Phone: 321-841-1764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberTRN23490
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: