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General NPI Number Information
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NPI Number | 1508920091
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Entity Type | Individual
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Provider Name | SARAH ANNE NEILLY M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1350 HICKORY ST
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City | MELBOURNE
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State | FL
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Zip | 32901-3224
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Country | US
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Telephone | 321-434-4225
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Fax | 321-434-4247
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Provider Business Mailing Address
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Address Line | 1304 OAK ST
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City | MELBOURNE
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State | FL
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Zip | 32901-3111
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Country | US
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Telephone | 321-723-4723
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Fax | 321-727-1448
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME94662
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 73696
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 73696
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME94662
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | ME94662
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License Number State | FL
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