Individual
JOHN GREGORY NEILY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
21550 ANGELA LN, VENICE, FL 34293-2017
(941) 493-7400
(941) 493-1940
Mailing address
21550 ANGELA LN, VENICE, FL 34293-2017
(941) 493-7400
(941) 493-1940
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS6785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80963
BLUE SHIELD ID NUMBER
FL
Enumeration date
11/13/2006
Last updated
03/01/2017
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