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Individual

GALE WILLIAMS GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4319 QUEENSBORO AVE S, SAINT PETERSBURG, FL 33711-2751
(727) 368-6088
Mailing address
PO BOX 11374, SAINT PETERSBURG, FL 33733-1374
(727) 368-6088
(727) 322-8441

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6922872 96
FL
Enumeration date
06/25/2007
Last updated
07/08/2007
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