Provider Demographics
NPI:1740255108
Name:GREENBERG, JEFFREY MARTIN (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MARTIN
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8955 SW 87TH CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2230
Mailing Address - Country:US
Mailing Address - Phone:305-279-2222
Mailing Address - Fax:305-279-2729
Practice Address - Street 1:8955 SW 87TH CT
Practice Address - Street 2:SUITE 101
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2230
Practice Address - Country:US
Practice Address - Phone:305-279-2222
Practice Address - Fax:305-279-2729
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88468Medicare ID - Type UnspecifiedMEDICARE
FLT55840Medicare UPIN