Provider Demographics
NPI:1154354355
Name:DIOLA, NEIL (RPT)
Entity type:Individual
Prefix:MR
First Name:NEIL
Middle Name:
Last Name:DIOLA
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4923 AUGUSTA AVE
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-6332
Mailing Address - Country:US
Mailing Address - Phone:727-688-1065
Mailing Address - Fax:727-362-0084
Practice Address - Street 1:7500 4TH ST N STE A
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5410
Practice Address - Country:US
Practice Address - Phone:727-688-1065
Practice Address - Fax:727-362-0084
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 8512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8889953Medicaid
FLU0235ZMedicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NO.