MEDICARE: NEAL BEIGHTOL, MD, PA

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	207Q00000X	Family Medicine Physician	ME69583	FL

General Provider Information

NPI Number	:	1952330722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEAL BEIGHTOL, MD, PA

Provider Business Mailing Address
First Line	:	PO BOX 7279
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34101-7279
Country	:	US
Telephone Number	:	239-649-5020
Fax Number	:	239-307-5193

Provider Business Practice Location Address
First Line	:	1845 SAN MARCO RD STE 303
Second Line	:
City	:	MARCO ISLAND
State	:	FL
Zip	:	34145-6712
Country	:	US
Telephone Number	:	239-649-5020
Fax Number	:	239-307-5193

Authorized Official
Title or Position	:	OWNER
Name	:	NEAL BEIGHTOL
Credential	:	MD
Telephone Number	:	239-649-5020

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	04/20/2021

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