MEDICARE: DR. SHAREEN M GREENBAUM MD

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	207W00000X	Ophthalmology Physician	ME97538	FL

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	:	1912039363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAREEN M GREENBAUM MD

Provider Business Mailing Address
First Line	:	9999 SHERIDAN ST
Second Line	:	STE 100
City	:	COOPER CITY
State	:	FL
Zip	:	33024-1531
Country	:	US
Telephone Number	:	954-447-0606
Fax Number	:	954-447-0605

Provider Business Practice Location Address
First Line	:	9999 SHERIDAN ST STE 100
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-3086
Country	:	US
Telephone Number	:	954-447-0606
Fax Number	:	954-447-0605

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	04/23/2024

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