Provider Demographics
NPI:1316192891
Name:GREENSTEIN, JONATHAN JAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JAY
Last Name:GREENSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4144 N. AMERICA AVE
Mailing Address - Street 2:SUITE #375
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6400
Mailing Address - Country:US
Mailing Address - Phone:813-875-8970
Mailing Address - Fax:813-875-4011
Practice Address - Street 1:4144 N. AMERICA AVE
Practice Address - Street 2:SUITE #375
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6400
Practice Address - Country:US
Practice Address - Phone:813-875-8970
Practice Address - Fax:813-875-4011
Is Sole Proprietor?:No
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0004388103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist