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General NPI Number Information
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NPI Number | 1780856401
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Entity Type | Organization
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Legal Business Name | DR. ALLAN GREEN DPM PA
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Dates
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Enumeration Date | 04/02/2008
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 7656 N NOB HILL RD
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City | TAMARAC
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State | FL
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Zip | 33321-1843
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Country | US
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Telephone | 954-724-3434
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Fax |
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Provider Business Mailing Address
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Address Line | 7656 N NOB HILL RD
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City | TAMARAC
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State | FL
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Zip | 33321-1843
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Country | US
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Telephone | 954-724-3434
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Fax |
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Authorized Official
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Title or Position | DPM
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Name | DR. ALLAN LOWELL GREEN
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Credential | DPM
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Telephone | 954-724-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO2261
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License Number State | FL
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