Provider Demographics
NPI:1992786172
Name:MACALI, NEIL E (OD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:E
Last Name:MACALI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1155 WINTER GARDEN VINELAND RD
Mailing Address - Street 2:STE 102
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4375
Mailing Address - Country:US
Mailing Address - Phone:407-656-3755
Mailing Address - Fax:407-656-5362
Practice Address - Street 1:1155 SOUTH VINELAND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787
Practice Address - Country:US
Practice Address - Phone:407-656-3755
Practice Address - Fax:407-656-5362
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC002373152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U24969Medicare UPIN
FL19242ZMedicare PIN