Provider Demographics
NPI:1225126519
Name:GREENFIELD, ADAM SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SCOTT
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 ENCLAVE DR
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677
Mailing Address - Country:US
Mailing Address - Phone:727-861-7043
Mailing Address - Fax:727-861-7382
Practice Address - Street 1:10806 US HIGHWAY 19
Practice Address - Street 2:SUITE 102A
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668
Practice Address - Country:US
Practice Address - Phone:727-861-7043
Practice Address - Fax:727-861-7382
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007496207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL256290100Medicaid
FL256290100Medicaid
G91815Medicare UPIN
FLK1687Medicare ID - Type Unspecified