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General NPI Number Information
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NPI Number | 1629289434
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Entity Type | Individual
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Provider Name | CAROL PAGE O'NEAL PT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 01/26/2009
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Provider Practice Location Address
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Address Line | 4401 S HOPKINS AVE SUITE 105-106
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City | TITUSVILLE
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State | FL
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Zip | 32780-6679
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Country | US
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Telephone | 321-383-0889
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Fax |
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Provider Business Mailing Address
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Address Line | 1571 N CARPENTER RD
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City | TITUSVILLE
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State | FL
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Zip | 32796-1171
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Country | US
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Telephone | 321-267-5132
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT2692
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License Number State | FL
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