Provider Demographics
NPI:1013002526
Name:GREENE, LEE H (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:H
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15300 JOG RD.
Mailing Address - Street 2:#205
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446
Mailing Address - Country:US
Mailing Address - Phone:561-496-7200
Mailing Address - Fax:561-496-7989
Practice Address - Street 1:15300 JOG RD.
Practice Address - Street 2:#205
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446
Practice Address - Country:US
Practice Address - Phone:561-496-7200
Practice Address - Fax:561-496-7989
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0032429207Q00000X
FLME105146207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine