Individual
ALISA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 7TH AVE N, ST PETERSBURG, FL 33705-1300
(727) 825-1000
Mailing address
1602 ATLANTIC DR, RUSKIN, FL 33570-4906
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
9327638
FL
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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