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General NPI Number Information
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NPI Number | 1699431411
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Entity Type | Organization
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Legal Business Name | KRISTIE GREENE, MD LLC
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Dates
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Enumeration Date | 11/16/2021
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 1617 S TUTTLE AVE STE 1A
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City | SARASOTA
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State | FL
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Zip | 34239-3132
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Country | US
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Telephone | 941-799-5753
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Fax | 888-814-0877
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Provider Business Mailing Address
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Address Line | 1617 S TUTTLE AVE STE 1A
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City | SARASOTA
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State | FL
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Zip | 34239-3132
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Country | US
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Telephone | 941-799-5753
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Fax | 888-814-0877
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIE GREENE
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Credential | MD
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Telephone | 941-799-5753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State |
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