Provider Demographics
NPI:1356760722
Name:URIL GREENE MD PA
Entity type:Organization
Organization Name:URIL GREENE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:URIL
Authorized Official - Middle Name:COYLETTE
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:1386-871-8535
Mailing Address - Street 1:27 RIVER RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4341
Mailing Address - Country:US
Mailing Address - Phone:386-871-8535
Mailing Address - Fax:386-269-4328
Practice Address - Street 1:1501 N US HIGHWAY 441
Practice Address - Street 2:BLDG 1800
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-8999
Practice Address - Country:US
Practice Address - Phone:352-751-8820
Practice Address - Fax:386-269-4328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92697207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty