Individual
DR. KEVIN M. NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3600
(904) 390-3429
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
ME86997
FL
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
ME86997
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189746312A
—
GA
05
—
266546800
—
FL
Enumeration date
08/10/2006
Last updated
09/22/2011
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