Provider Demographics
NPI:1619794559
Name:MCNEILL, NATALIE ROSE (PT, DPT)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ROSE
Last Name:MCNEILL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:ROSE-MCNEILL
Other - Last Name:SAMPSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:13786 SW 32ND TERRACE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-2262
Mailing Address - Country:US
Mailing Address - Phone:916-768-4575
Mailing Address - Fax:
Practice Address - Street 1:13786 SW 32ND TERRACE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-2262
Practice Address - Country:US
Practice Address - Phone:916-768-4575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295279225100000X
FL35206225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist