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Individual

MAGGIE GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AA

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0011
Mailing address
3605 WARRENSVILLE CENTER ROAD, 1ST FLOOR, SHAKER HTS, OH 44122
(216) 286-6260
(216) 286-6341

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
1559
GA
367H00000X
Anesthesiologist Assistant
67.000136
OH
367H00000X
Anesthesiologist Assistant
Primary
AA505
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000234673
UNISON
OH
01
000000558049
ANTHEM
OH
01
0583328
BCMH
OH
05
2835614
OH
01
9091135
AETNA
OH
01
P00469470
MEDICARE RAILROAD
OH
Enumeration date
07/25/2007
Last updated
06/11/2025
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