Individual
ROBERTA (BOBBI) NEALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4035 GRANT RD, JACKSONVILLE, FL 32207-6630
(904) 253-1148
Mailing address
9471 BEAUCLERC COVE LN, JACKSONVILLE, FL 32257-5430
(904) 731-8017
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1793911875281-5A
DCHD BADGE ID#
FL
01
—
N400-736-72-648-0
FLORIDA DRIVERS LICENSE
FL
Enumeration date
06/15/2012
Last updated
06/15/2012
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