MEDICARE: SYDNEY GREEN

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	225XP0200X	Pediatric Occupational Therapist	OT22232	FL

General Provider Information

NPI Number	:	1134083439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY GREEN

Provider Business Mailing Address
First Line	:	5981 ASHFORD LN
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34110-2396
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	866 99TH AVE N
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34108-2234
Country	:	US
Telephone Number	:	239-392-1070
Fax Number	:

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

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ SYDNEY GREEN ” Practice Location

Language	Start Address	Practice Location

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