Organization
RICHARD A. GREENE, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ALAN GREENE O.D. (OPTOMETRIST/OWNER)
(904) 471-8750
Entity
Organization
Contact information
Practice address
2225 A1A S, SUITE C2, SAINT AUGUSTINE, FL 32080-2916
(904) 471-8750
(904) 471-5996
Mailing address
2225 A1A S, SUITE C2, SAINT AUGUSTINE, FL 32080-2916
(904) 471-8750
(904) 471-5996
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
FL1648
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114039336
INDIVIDUAL NPI
FL
Enumeration date
01/25/2011
Last updated
01/25/2011
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