Provider Demographics
NPI:1093900417
Name:PEDRO J GREER MD & ASSOCIATES PA
Entity Type:Organization
Organization Name:PEDRO J GREER MD & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:GREER JR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-856-1541
Mailing Address - Street 1:3661 S MIAMI AVE
Mailing Address - Street 2:SUITE 805
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4236
Mailing Address - Country:US
Mailing Address - Phone:305-856-7333
Mailing Address - Fax:305-856-8030
Practice Address - Street 1:3661 S MIAMI AVE
Practice Address - Street 2:SUITE 805
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4236
Practice Address - Country:US
Practice Address - Phone:305-856-7333
Practice Address - Fax:305-856-8030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047468174400000X
FLME0087519174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267018600Medicaid
FL062810701Medicaid
FL062810701Medicaid
FLF01138Medicare UPIN
FL11635Medicare PIN
FL79070Medicare PIN