Healthcare Provider Details

I. General information

NPI: 1922502301
Provider Name (Legal Business Name): MITCHELL GREENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 CAMINO REAL STE 210
BOCA RATON FL
33433-5532
US

IV. Provider business mailing address

2001 W SAMPLE RD STE 420
DEERFIELD BEACH FL
33064-1341
US

V. Phone/Fax

Practice location:
  • Phone: 561-462-2020
  • Fax: 561-421-6220
Mailing address:
  • Phone: 561-226-4922
  • Fax: 561-292-0922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME157368
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: