MEDICARE: DR. ROBERT COLLINS GREER IV D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	3909	FL

General Provider Information

NPI Number	:	1053319533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT COLLINS GREER IV D.O.

Provider Business Mailing Address
First Line	:	624 US 1
Second Line	:
City	:	LAKE PARK
State	:	FL
Zip	:	33403-2916
Country	:	US
Telephone Number	:	561-844-2464
Fax Number	:	561-844-1250

Provider Business Practice Location Address
First Line	:	624 US 1
Second Line	:
City	:	LAKE PARK
State	:	FL
Zip	:	33403-2916
Country	:	US
Telephone Number	:	561-844-2464
Fax Number	:	561-844-1250

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	04/21/2011

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