Provider Demographics
NPI:1952586505
Name:DRS. WILLENS & GREENBERG, PA
Entity Type:Organization
Organization Name:DRS. WILLENS & GREENBERG, PA
Other - Org Name:HOLLYWOOD PODIATRY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:954-923-1800
Mailing Address - Street 1:2651 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4840
Mailing Address - Country:US
Mailing Address - Phone:954-923-1800
Mailing Address - Fax:954-921-0599
Practice Address - Street 1:2651 HOLLYWOOD BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4840
Practice Address - Country:US
Practice Address - Phone:954-923-1800
Practice Address - Fax:954-921-0599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02137770Medicaid
FL87639OtherMEDICARE ID
FLT55483Medicare UPIN