Provider Demographics
NPI:1043262389
Name:GREENE, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
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 1:1000 GOODLETTE RD N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5474
Mailing Address - Country:US
Mailing Address - Phone:239-434-6200
Mailing Address - Fax:
Practice Address - Street 1:1112 GOODLETTE RD N STE 203
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5499
Practice Address - Country:US
Practice Address - Phone:239-263-8444
Practice Address - Fax:239-263-6120
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLME0078059207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME78059OtherFLORIDA DEPARTMENT OF HEALTH
FL46585XMedicare PIN
FLG67909Medicare UPIN