Provider Demographics
NPI:1245510171
Name:NEYRA, HAROLD DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:DAVID
Last Name:NEYRA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 RED BUG LAKE RD STE 2030
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6828
Mailing Address - Country:US
Mailing Address - Phone:407-319-4260
Mailing Address - Fax:407-365-7538
Practice Address - Street 1:8400 RED BUG LAKE RD STE 1010
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6835
Practice Address - Country:US
Practice Address - Phone:407-890-4990
Practice Address - Fax:073-657-0534
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT053129208600000X
390200000X
FLOS14159208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLN1UDVOtherFLORIDA BLUE