Provider Demographics
NPI:1194030908
Name:RHYNES, GRETA D
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:D
Last Name:RHYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 682428
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32868-2428
Mailing Address - Country:US
Mailing Address - Phone:407-453-8138
Mailing Address - Fax:
Practice Address - Street 1:4678 MIDDLEBROOK RD
Practice Address - Street 2:APT. G
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-6748
Practice Address - Country:US
Practice Address - Phone:407-453-8138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker