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Individual
OTIS GREEN
Active
Individual
OTIS GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME180065
FL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/02/2021
Last updated
03/30/2026
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