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NPI Code Detail

MEDICARE: JANISH LEE GREEN FNP

MEDICARE:   JANISH LEE GREEN  FNP
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
1363LF0000XFamily Nurse PractitionerAPRN11011986FL
2363LF0000XFamily Nurse Practitioner0024178370VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275180200
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANISH LEE GREEN FNP
Provider Business Mailing Address
First Line : 5650 RED BUG LAKE RD
Second Line :
City : WINTER SPRINGS
State : FL
Zip : 32708-4904
Country : US
Telephone Number : 407-699-0781
Fax Number :
Provider Business Practice Location Address
First Line : 5650 RED BUG LAKE RD
Second Line :
City : WINTER SPRINGS
State : FL
Zip : 32708-4904
Country : US
Telephone Number : 407-699-0781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2019
Last Update Date : 04/19/2026

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Directions to “ JANISH LEE GREEN FNP” Practice Location

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