MEDICARE: GEOFFREY E MCNEAVE CST, CSFA, CSA

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	246ZS0410X	Surgical Technologist	177475
2	246ZC0007X	Surgical Assistant	177475

General Provider Information

NPI Number	:	1912559048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEOFFREY E MCNEAVE CST, CSFA, CSA

Provider Business Mailing Address
First Line	:	6410 KEY ISLAND AVE
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-2571
Country	:	US
Telephone Number	:	727-543-2057
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 KEY ISLAND AVE
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-2571
Country	:	US
Telephone Number	:	727-543-2057
Fax Number	:

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

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	11/02/2023

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