Provider Demographics
NPI:1194525014
Name:O'NEILL, DYLAN REED
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:REED
Last Name:O'NEILL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 DONALD DR SW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-7203
Mailing Address - Country:US
Mailing Address - Phone:330-306-5773
Mailing Address - Fax:
Practice Address - Street 1:5900 LAKE ELLENOR DR STE 150
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4663
Practice Address - Country:US
Practice Address - Phone:407-393-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program