Healthcare Provider Details

I. General information

NPI: 1821013566
Provider Name (Legal Business Name): WILLIAM CHARLES GREENBERG APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301A W PALMETTO PARK RD SUITE 106-C
BOCA RATON FL
33433-3409
US

IV. Provider business mailing address

7301A W PALMETTO PARK RD SUITE 106-C
BOCA RATON FL
33433-3409
US

V. Phone/Fax

Practice location:
  • Phone: 561-391-4669
  • Fax: 561-391-1815
Mailing address:
  • Phone: 561-391-4669
  • Fax: 561-391-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberCNS 9437804
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: