MEDICARE: ERRITY 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	103K00000X	Behavior Analyst

Other Identifiers

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

General Provider Information

NPI Number	:	1366757817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERRITY GREEN

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1413 TECH BLVD STE 122
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7822
Country	:	US
Telephone Number	:	941-264-8135
Fax Number	:

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

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	04/22/2022

Similar Medicare Providers

1306448022 — BRI'ANNA DOSTER
Practice Location Address:

1413 TECH BLVD STE 125
TAMPA, FL
33619-7822

Practice Phone: 813-551-2890
Practice Fax:

1366631061 — MEDERI CARETENDERS VS OF TAMPA, LLC
Practice Location Address:

1413 TECH BLVD STE 125
TAMPA, FL
33619-7822

Practice Phone: 813-282-8520
Practice Fax: 813-282-8530

1669795829 — JENNIFER L DEIEN M.S., BCBA
Practice Location Address:

1413 TECH BLVD STE 122
TAMPA, FL
33619-7822

Practice Phone: 855-832-6727
Practice Fax:

1992007561 — SUNCREST HOME HEALTH OF TAMPA, LLC
Practice Location Address:

1413 TECH BLVD STE 122
TAMPA, FL
33619-7822

Practice Phone: 813-288-8001
Practice Fax: 813-288-9501

1255772125 — MISS BLAIR NICHOLE ORTMAN BCBA
Practice Location Address:

1413 TECH BLVD STE 122
TAMPA, FL
33619-7822

Practice Phone: 855-832-6727
Practice Fax:

1114342052 — MAURA MATSEN
Practice Location Address:

1413 TECH BLVD STE 122
TAMPA, FL
33619-7822

Practice Phone: 855-832-6727
Practice Fax: 772-675-9100

Directions to “ ERRITY GREEN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.