Healthcare Provider Details

I. General information

NPI: 1578759791
Provider Name (Legal Business Name): MAUREEN GREENWOOD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2866 E OAKLAND PARK BLVD STE 2
FORT LAUDERDALE FL
33306-1819
US

IV. Provider business mailing address

6255 W SUNSET BLVD FL 21
LOS ANGELES CA
90028-7422
US

V. Phone/Fax

Practice location:
  • Phone: 954-561-6900
  • Fax: 954-568-7021
Mailing address:
  • Phone: 323-860-5200
  • Fax: 323-467-7119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP2213832
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: