Individual
DR. AGNES P GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7315 HUDSON AVE, HUDSON, FL 34667-1158
(727) 868-9563
(727) 869-6909
Mailing address
PO BOX 5477, HUDSON, FL 34674-5477
(727) 868-9563
(727) 869-6909
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME92890
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16663
BLUE CROSS
FL
01
—
ME92890
STATE LISCENSE
FL
Enumeration date
01/10/2007
Last updated
07/08/2007
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