Provider Demographics
NPI:1851637284
Name:HEATHER NEELEY MD PA
Entity Type:Organization
Organization Name:HEATHER NEELEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-446-8866
Mailing Address - Street 1:905 E MARTIN LUTHER KING JR DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-4864
Mailing Address - Country:US
Mailing Address - Phone:727-446-8866
Mailing Address - Fax:727-446-2277
Practice Address - Street 1:905 E MARTIN LUTHER KING JR DR
Practice Address - Street 2:SUITE 430
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-4864
Practice Address - Country:US
Practice Address - Phone:727-446-8866
Practice Address - Fax:727-446-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty