Provider Demographics
NPI:1164463147
Name:GREENE, DAINA PAIGE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAINA
Middle Name:PAIGE
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:2 SHIRCLIFF WAY STE 600
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4762
Practice Address - Country:US
Practice Address - Phone:904-387-9577
Practice Address - Fax:904-387-9245
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME95384207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275812100Medicaid