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Individual

NEIL MOUDGILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2 TAMPA GENERAL CIR, STC 3RD FLOOR, TAMPA, FL 33606-3603
(813) 259-0956
(813) 259-0606
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD431182
PA
2086S0129X
Vascular Surgery Physician
Primary
ME114031
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
007868400
FL
01
14N1U
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/18/2007
Last updated
03/05/2013
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