Healthcare Provider Details

I. General information

NPI: 1124237664
Provider Name (Legal Business Name): PHILLIP ERIC GREENBARG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 SHERIDAN ST
HOLLYWOOD FL
33021-3535
US

IV. Provider business mailing address

3389 SHERIDAN ST #301
HOLLYWOOD FL
33021-3606
US

V. Phone/Fax

Practice location:
  • Phone: 954-966-6450
  • Fax:
Mailing address:
  • Phone: 954-966-6450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number40335
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: