Individual
ALIA DEYIRA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2626 CAPITAL MEDICAL BLVD, TALLAHASSEE, FL 32308-4402
(850) 325-5000
Mailing address
202 S SHADOW ST, QUINCY, FL 32351-3343
(850) 322-7094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E-17218
AR
207Q00000X
Family Medicine Physician
Primary
ME171017
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/14/2022
Last updated
06/27/2025
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