Individual
DR. CLINTON RANDALL GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
12550 NEW BRITTANY BLVD STE 100, FORT MYERS, FL 33907-3655
(239) 343-9180
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-9180
(239) 343-9188
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY12350
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128045200
—
FL
Enumeration date
08/27/2024
Last updated
10/15/2025
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