Provider Demographics
NPI:1336627991
Name:GREENE, LINDSEY N (DOT)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:N
Last Name:GREENE
Suffix:
Gender:F
Credentials:DOT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:N
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOT
Mailing Address - Street 1:11246 SW OLMSTEAD DRIVE
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-1945
Mailing Address - Country:US
Mailing Address - Phone:954-579-5619
Mailing Address - Fax:772-673-0523
Practice Address - Street 1:11246 SW OLMSTEAD DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-1945
Practice Address - Country:US
Practice Address - Phone:954-579-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-04
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK136528225X00000X
FLOT21809225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist