Provider Demographics
NPI:1730106204
Name:GREEN, BARTH ARMAND (MD)
Entity Type:Individual
Prefix:MR
First Name:BARTH
Middle Name:ARMAND
Last Name:GREEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1095 NW 14TH TERRACE
Mailing Address - Street 2:D4-6
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136
Mailing Address - Country:US
Mailing Address - Phone:305-243-6946
Mailing Address - Fax:305-243-3337
Practice Address - Street 1:1475 NW 12TH AVENUE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-243-6946
Practice Address - Fax:305-243-3337
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME26506207T00000X
FLME0026506207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0556408-00Medicaid
FL55640800Medicaid
FL0556408-00Medicaid
FLD59974Medicare UPIN