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Individual

DR. JARED ROSS GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1005 JOE DIMAGGIO DR, HOLLYWOOD, FL 33021-5402
(954) 265-5892
Mailing address
500 N HIATUS RD STE 200, PEMBROKE PINES, FL 33026-5213
(954) 437-4800
(954) 437-6628

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
036.130117
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036.130117
IL

Other

Enumeration date
04/15/2008
Last updated
04/07/2022
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