Organization
KEVIN J GREENWOOD P A
Active
Other names
Kevin J Greenwood P A
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN J GREENWOOD CRNA (PRESIDENT)
(727) 376-9097
Entity
Organization
Contact information
Practice address
9540 VENTURI DR, TRINITY, FL 34655-4645
(727) 376-9097
(813) 433-5540
Mailing address
9540 VENTURI DR, TRINITY, FL 34655-4645
(727) 376-9097
(813) 433-5540
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AN1633502
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G0174
MEDICARE PTAN
FL
Enumeration date
01/26/2012
Last updated
01/26/2012
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