Provider Demographics
NPI:1518533728
Name:JEROLD S GREENFIELD O.D. P.A.
Entity Type:Organization
Organization Name:JEROLD S GREENFIELD O.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEROLD
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-536-6756
Mailing Address - Street 1:5100 N 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8735
Mailing Address - Country:US
Mailing Address - Phone:850-477-7646
Mailing Address - Fax:850-477-7128
Practice Address - Street 1:5100 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8735
Practice Address - Country:US
Practice Address - Phone:850-477-7646
Practice Address - Fax:850-477-7128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty