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Contact Information

NEAL M BULLOCK, DPM
17013 PINES BLVD
PEMBROKE PINES, FL33027-1003
 Phone: 954-450-4200
 Fax: 954-450-4237
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for NEAL M BULLOCK · (Male)

NPI Number 1902912793
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 08/22/2006
Last updated 05/20/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PO0002571
  • FL Medicaid 390394000
  • FL Other 65515 BLUE CROSS BLUE SHIELD
Hospital affiliation(s)
  • WESTSIDE REGIONAL MEDICAL CENTER - (Acute Care)
    8201 W BROWARD BLVD
    PLANTATION, FL 33324
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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