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Individual

ILEY COLEMAN NEELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5601 N DIXIE HWY, STE 115, FT. LAUDERDALE, FL 33334
(954) 771-4271
(954) 776-5959
Mailing address
PO BOX 31796, TAMPA, FL 33631-3796
(954) 851-9966
(954) 318-7350

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME57956
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0400878
GHI
01
0800138
UNITED HEALTHCARE
01
10480
BCBS
FL
01
180033429
RAILROAD MEDICARE
01
5443058
AETNA
01
591932202
HUMANA
Enumeration date
07/10/2006
Last updated
03/22/2021
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