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NPI Code Detail

MEDICARE: DR. KYLE JOSEPH NEAL PHARMD

MEDICARE: DR. KYLE JOSEPH NEAL PHARMD
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
1183500000XPharmacistPS56283FL

General Provider Information

NPI Number : 1184154379
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE JOSEPH NEAL PHARMD
Provider Business Mailing Address
First Line : 3050 TAMAYA BLVD APT 102
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-1212
Country : US
Telephone Number : 352-584-0563
Fax Number :
Provider Business Practice Location Address
First Line : 11264 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32246-3802
Country : US
Telephone Number : 904-641-5411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2017
Last Update Date : 06/19/2017

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