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Individual

DR. ROBERT J GREENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
5190 26TH ST W STE F, BRADENTON, FL 34207-2200
(941) 753-1686
(941) 753-9797
Mailing address
5190 26TH ST W STE F, BRADENTON, FL 34207-2200
(941) 753-1686
(941) 753-9797

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY2249
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
592332042001
MEDICAL MUTUAL
FL
01
6887368
GHI
FL
01
75102
BCBS
FL
Enumeration date
03/02/2007
Last updated
11/09/2010
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