Provider Demographics
NPI:1639140031
Name:O'NEIL, GEORGE J JR (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:J
Last Name:O'NEIL
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 NORTHPOINT PARKWAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:561-275-7604
Mailing Address - Fax:561-802-5385
Practice Address - Street 1:927 45TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2450
Practice Address - Country:US
Practice Address - Phone:561-881-5454
Practice Address - Fax:561-881-5559
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036060402207V00000X
FLME118388207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013308300Medicaid
IL036060402Medicaid
ILD93841Medicare UPIN
IL660360Medicare ID - Type Unspecified
IL036060402Medicaid