Individual
DR. KENNETH W NEELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 725-4505
(321) 409-8932
Mailing address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 725-4505
(321) 409-8932
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME0043115
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
069717600
—
FL
Enumeration date
10/17/2006
Last updated
07/01/2010
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