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Individual

JOHN GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-7208
(813) 745-3071
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME50982
FL
207RI0200X
Infectious Disease Physician
Primary
ME50982
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07351
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/13/2006
Last updated
01/16/2008
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