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General NPI Number Information
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NPI Number | 1326362310
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Entity Type | Organization
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Legal Business Name | GLORIA E MCNEIL MD., PL
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 2402 FRIST BLVD
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City | FORT PIERCE
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State | FL
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Zip | 34950-4838
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Country | US
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Telephone | 772-462-6606
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Fax | 772-462-6681
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Provider Business Mailing Address
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Address Line | PO BOX 3079
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City | FORT PIERCE
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State | FL
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Zip | 34948-3079
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Country | US
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Telephone | 772-812-1352
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLORIA ELAINE MCNEIL
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Credential |
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Telephone | 772-462-6606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 0075634
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License Number State | FL
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