Provider Demographics
NPI:1780250647
Name:GREENE, AALIYAH MARIE (CAREGIVER)
Entity type:Individual
Prefix:
First Name:AALIYAH
Middle Name:MARIE
Last Name:GREENE
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 SW 27TH AVE APT 2605
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2061
Mailing Address - Country:US
Mailing Address - Phone:863-458-3387
Mailing Address - Fax:
Practice Address - Street 1:1601 SW 27TH AVE APT 2605
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2061
Practice Address - Country:US
Practice Address - Phone:863-458-3387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion