Provider Demographics
NPI:1356810535
Name:NEAL, GALENE VICTORIA (APRN)
Entity type:Individual
Prefix:
First Name:GALENE
Middle Name:VICTORIA
Last Name:NEAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:GALENE
Other - Middle Name:V
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:GALENA NEAL, FNP-BC
Mailing Address - Street 1:13599 ALPINE AVE
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33776-3032
Mailing Address - Country:US
Mailing Address - Phone:727-242-1111
Mailing Address - Fax:
Practice Address - Street 1:12464 INDIAN ROCKS RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3005
Practice Address - Country:US
Practice Address - Phone:727-596-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-17
Last Update Date:2018-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11000135363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily