Provider Demographics
NPI:1417121260
Name:NEAGU, DANIELA LILIANA (MD)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:LILIANA
Last Name:NEAGU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40767
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32203-0767
Mailing Address - Country:US
Mailing Address - Phone:904-376-3707
Mailing Address - Fax:
Practice Address - Street 1:841 PRUDENTIAL DR STE 280
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-8350
Practice Address - Country:US
Practice Address - Phone:904-202-8550
Practice Address - Fax:904-393-7808
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXFT423772080P0202X
NJ25MA077704002080P0202X
FLTRN92352080P0202X
FLME1126442080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14K20OtherBCBSFL
TX8L3849OtherMEDICARE CMS
FL004777200Medicaid
GA003123602AMedicaid
TX198967501Medicaid
TX8L3849OtherMEDICARE CMS