Individual
DR. JEREMY BLAIR GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4425 PONCE DE LEON BLVD, SUITE 200, CORAL GABLES, FL 33146-1837
(305) 443-6606
(305) 443-4890
Mailing address
4425 PONCE DE LEON BLVD, SUITE 200, CORAL GABLES, FL 33146-1837
(305) 443-6606
(305) 443-4890
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME107541
FL
207NS0135X
Procedural Dermatology Physician
ME107541
FL
Other
Enumeration date
05/24/2007
Last updated
08/22/2011
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