Individual
NEAL M BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
17013 PINES BLVD, PEMBROKE PINES, FL 33027-1003
(954) 450-4200
(954) 450-4237
Mailing address
17013 PINES BLVD, PEMBROKE PINES, FL 33027-1003
(954) 450-4200
(954) 450-4237
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO0002571
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390394000
—
FL
01
—
65515
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/22/2006
Last updated
05/20/2011
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