Organization
GREENBROOK MEDICAL PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJ MACHHAR MD (CHIEF MEDICAL OFFICER)
(813) 443-3399
Entity
Organization
Contact information
Practice address
11200 E DR MARTIN LUTHER KING JR BLVD STE 107, SEFFNER, FL 33584-8351
(813) 443-3399
Mailing address
11200 E DR MARTIN LUTHER KING JR BLVD STE 107, SEFFNER, FL 33584-8351
(813) 443-3399
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
08/09/2023
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