Provider Demographics
NPI:1386647725
Name:GREENE, THOMAS LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 W. DR. M. L. KING JR. BLVD.
Mailing Address - Street 2:SUITE 560
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6009
Mailing Address - Country:US
Mailing Address - Phone:813-873-0337
Mailing Address - Fax:813-873-0151
Practice Address - Street 1:2727 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:STE 560
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6009
Practice Address - Country:US
Practice Address - Phone:813-873-0337
Practice Address - Fax:813-873-0151
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042436207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
D54056Medicare UPIN