# DAVID J GREEN, MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396097903
- **Authorized official:** DR. DAVID J GREEN MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (863) 291-3732

## Contact information

- **Practice address:** 7000 STATE ROAD 544, STE 7, WINTER HAVEN, FL 33881-9536
- **Practice address phone:** (863) 291-3732
- **Practice address fax:** (863) 299-6287
- **Mailing address:** 7000 STATE ROAD 544, STE 7, WINTER HAVEN, FL 33881-9536
- **Mailing address phone:** (863) 291-3732
- **Mailing address fax:** (863) 299-6287

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | ME0029242 | FL | Yes |

## Other

- **Enumeration date:** 10/05/2012
- **Last updated:** 10/18/2012