Provider Demographics
NPI:1760907182
Name:GREINER, ROBERT
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GREINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11400 5TH ST E
Mailing Address - Street 2:
Mailing Address - City:TREASURE ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33706-3016
Mailing Address - Country:US
Mailing Address - Phone:813-373-9217
Mailing Address - Fax:
Practice Address - Street 1:23988 US HIGHWAY 19 N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1563
Practice Address - Country:US
Practice Address - Phone:727-441-3591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS51072355A2700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology Assistant