Provider Demographics
NPI:1336222587
Name:NEUZIL, FRANCIS E JR (ARNP)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:E
Last Name:NEUZIL
Suffix:JR
Gender:M
Credentials:ARNP
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 1804
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32158-1804
Mailing Address - Country:US
Mailing Address - Phone:352-750-1999
Mailing Address - Fax:352-750-1998
Practice Address - Street 1:309 LA GRANDE BOULEVARD
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159
Practice Address - Country:US
Practice Address - Phone:352-750-1999
Practice Address - Fax:352-750-1998
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2946932363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY8614OtherBLUE CROSS / BLUE SHIELD
S92996Medicare UPIN
FLY8614OtherBLUE CROSS / BLUE SHIELD