Individual
DR. JOSHUA T. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3325 S TAMIAMI TRL STE 200, SARASOTA, FL 34239-5114
(941) 917-8488
(941) 917-8475
Mailing address
2160 COLONIAL BLVD, FORT MYERS, FL 33907-1410
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME69452
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1193067
WELLCARE
FL
01
—
216498
AMERIGROUP PROV. #
FL
05
—
260096000
—
FL
01
—
340018101
MEDICARE RR
FL
01
—
42437
BCBS
FL
01
—
7707156
AETNA PROVIDER #
FL
01
—
9479252
CIGNA PROVIDER #
FL
01
—
P00449112
RAILROAD MEDICARE
FL
Enumeration date
08/22/2005
Last updated
07/21/2022
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