MEDICARE: DR. THOMAS JAY NEILSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME82070	FL
2	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	ME82070	FL

General Provider Information

NPI Number	:	1174549034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JAY NEILSON M.D.

Provider Business Mailing Address
First Line	:	500 WATER ST # J-290
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32202-4423
Country	:	US
Telephone Number	:	904-359-7645
Fax Number	:	904-359-3313

Provider Business Practice Location Address
First Line	:	500 WATER ST # J-290
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32202-4423
Country	:	US
Telephone Number	:	904-359-7645
Fax Number	:	904-359-3313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	09/11/2025

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