Provider Demographics
NPI:1700819620
Name:GREENBERG, BARNEY AARON (DPM)
Entity Type:Individual
Prefix:MR
First Name:BARNEY
Middle Name:AARON
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4840
Mailing Address - Country:US
Mailing Address - Phone:954-923-1800
Mailing Address - Fax:954-921-0599
Practice Address - Street 1:2651 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4840
Practice Address - Country:US
Practice Address - Phone:954-923-1800
Practice Address - Fax:954-921-0599
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 1175213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041232500Medicaid
FLT55483Medicare UPIN
FL87639Medicare PIN
FL041232500Medicaid