Provider Demographics
NPI:1740373158
Name:REBEKAH GREER PA
Entity type:Organization
Organization Name:REBEKAH GREER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:941-915-7077
Mailing Address - Street 1:3341 FAUNA ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-6606
Mailing Address - Country:US
Mailing Address - Phone:941-915-7077
Mailing Address - Fax:866-247-4268
Practice Address - Street 1:3341 FAUNA ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-6606
Practice Address - Country:US
Practice Address - Phone:941-915-7077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8540235Z00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890404900Medicaid
FL812002100Medicaid