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General NPI Number Information
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NPI Number | 1114977477
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Entity Type | Individual
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Provider Name | NEIL GARRETT POWELL JR. MD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 2525 HARBOR BLVD STE 105
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5338
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Country | US
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Telephone | 850-585-3145
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Fax |
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Provider Business Mailing Address
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Address Line | 2525 HARBOR BLVD STE 105
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-5338
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Country | US
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Telephone | 850-585-3145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | ME50079
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD35799
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | LT15664
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | M-2045
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License Number State | GU
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