Provider Demographics
NPI:1588607394
Name:GRECO, JOSEPH FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:GRECO
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 1:401 INTERSTATE BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-8996
Mailing Address - Country:US
Mailing Address - Phone:941-312-5027
Mailing Address - Fax:
Practice Address - Street 1:1990 MAIN ST STE 700
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-5955
Practice Address - Country:US
Practice Address - Phone:941-867-3376
Practice Address - Fax:941-667-5544
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95431207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A954310Medicaid
CAI69257Medicare UPIN
CA00A954310Medicaid