Provider Demographics
NPI:1831176593
Name:WILLAIM R. GREENBERG MD LLC
Entity type:Organization
Organization Name:WILLAIM R. GREENBERG MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-549-8107
Mailing Address - Street 1:801 W BAY DR
Mailing Address - Street 2:SUITE 431
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3269
Mailing Address - Country:US
Mailing Address - Phone:727-549-8107
Mailing Address - Fax:727-549-8720
Practice Address - Street 1:801 W BAY DR
Practice Address - Street 2:SUITE 431
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3269
Practice Address - Country:US
Practice Address - Phone:727-549-8107
Practice Address - Fax:727-549-8720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-23
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME397772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
130000533OtherRAILROAD MEDICARE
130000533OtherRAILROAD MEDICARE
FLD65337Medicare UPIN