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General NPI Number Information
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NPI Number | 1154709384
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Entity Type | Individual
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Provider Name | TIFFANY H GREEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 2901 RIGSBY LN STE G
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-4828
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Country | US
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Telephone | 727-287-1250
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Fax | 727-287-1270
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Provider Business Mailing Address
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Address Line | 9960 NW 116TH WAY STE 13
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City | MEDLEY
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State | FL
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Zip | 33178-1175
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Country | US
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Telephone | 786-924-1311
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Fax | 786-924-1313
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME147063
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License Number State | FL
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