Individual
KEVIN ROY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1004 S OLD DIXIE HWY STE 202, JUPITER, FL 33458-7200
(561) 745-6950
(561) 263-7260
Mailing address
PO BOX 9218, JUPITER, FL 33468-9218
(612) 637-2575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME140303
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME140303
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2016
Last updated
02/06/2024
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