Provider Demographics
NPI:1114088028
Name:ONEAL, MICHAEL L (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:ONEAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 N MCMULLEN BOOTH RD
Mailing Address - Street 2:C1
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2032
Mailing Address - Country:US
Mailing Address - Phone:727-784-8829
Mailing Address - Fax:727-784-7718
Practice Address - Street 1:3165 N MCMULLEN BOOTH RD
Practice Address - Street 2:C1
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2032
Practice Address - Country:US
Practice Address - Phone:727-784-8829
Practice Address - Fax:727-784-7718
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8736173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH70028Medicare UPIN
FLE8089ZMedicare PIN