Individual
TANTALAINE M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5226 BRIGHTON PARK LN, JACKSONVILLE, FL 32210-9260
(904) 894-6843
Mailing address
5226 BRIGHTON PARK LN, JACKSONVILLE, FL 32210-9260
(904) 894-6843
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
374U00000X
FL
374U00000X
Home Health Aide
Primary
—
FL
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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