Healthcare Provider Details

I. General information

NPI: 1689699985
Provider Name (Legal Business Name): HARVEY M. GREENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 N MILLS AVE
ORLANDO FL
32803-1834
US

IV. Provider business mailing address

1812 N MILLS AVE
ORLANDO FL
32803-1834
US

V. Phone/Fax

Practice location:
  • Phone: 407-956-3300
  • Fax:
Mailing address:
  • Phone: 407-956-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME38177
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME38177
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License NumberME38177
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberME38177
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: