Organization
STACY GREETER, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY LYNN GREETER MD (PHYSICIAN)
(904) 228-0777
Entity
Organization
Contact information
Practice address
9030 58TH DR E, SUITE 101A, ROOM A, BRADENTON, FL 34202-6108
(941) 413-0834
(941) 761-5547
Mailing address
9030 58TH DR E, SUITE 101A, ROOM A, BRADENTON, FL 34202-6108
(941) 413-0834
(941) 761-5547
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
ME 128423
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1215257845
INDIVIDUAL NPI
FL
Enumeration date
04/26/2017
Last updated
04/26/2017
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