Provider Demographics
NPI:1497376719
Name:MCNEIL-MASUKA, JANELLE (MD)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:MCNEIL-MASUKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33622-5201
Mailing Address - Country:US
Mailing Address - Phone:727-823-2188
Mailing Address - Fax:727-828-0723
Practice Address - Street 1:2310 NORTH BLVD W STE A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-8988
Practice Address - Country:US
Practice Address - Phone:813-701-5804
Practice Address - Fax:813-291-7615
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-01098207LP2900X
NC261448390200000X
FLME173315207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program