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Individual

RONALDO ANTONIO GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C, ATC

Contact information

Practice address
60 COLUMBIA ST, ORLANDO, FL 32806-1115
(321) 843-2584
Mailing address
121 HABERSHAM DR, LONGWOOD, FL 32779-4501

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL4575
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9119963
FL

Other

Enumeration date
05/16/2019
Last updated
04/29/2025
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