Healthcare Provider Details

I. General information

NPI: 1982711420
Provider Name (Legal Business Name): DAVID S. GREENFIELD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10,000 BAY PINES BLVD.
BAY PINES FL
33744
US

IV. Provider business mailing address

13966 OAK FOREST BLVD N
SEMINOLE FL
33776-3417
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-6661
  • Fax: 727-398-9509
Mailing address:
  • Phone: 727-392-2061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPY4607
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: