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General NPI Number Information
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NPI Number | 1407102247
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Entity Type | Organization
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Legal Business Name | HOLLYWOOD EYE INSTITUTE, PA
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 11011 SHERIDAN ST SUITE 215
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1505
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Country | US
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Telephone | 954-447-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 11011 SHERIDAN ST SUITE 215
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1505
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Country | US
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Telephone | 954-447-0606
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAREEN GREENBAUM
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Credential | M.D.
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Telephone | 954-447-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME97538
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License Number State | FL
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