Provider Demographics
NPI:1679713879
Name:O'NEILL, EDWARD BERNARD JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:BERNARD
Last Name:O'NEILL
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5751 HOOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-5340
Mailing Address - Country:US
Mailing Address - Phone:813-886-8334
Mailing Address - Fax:813-890-0143
Practice Address - Street 1:5751 HOOVER BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5340
Practice Address - Country:US
Practice Address - Phone:813-886-8334
Practice Address - Fax:813-890-0143
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2018-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA390200000X207ZP0102X
FLME113130207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology