MEDICARE: JONATHAN GREENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	ME50725	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063605871
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN GREENBERG MD

Provider Business Mailing Address
First Line	:	1517 E ROBINSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2121
Country	:	US
Telephone Number	:	407-648-9500
Fax Number	:	407-648-5558

Provider Business Practice Location Address
First Line	:	1517 E ROBINSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2121
Country	:	US
Telephone Number	:	407-648-9500
Fax Number	:	407-648-5558

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN GREENBERG
Credential	:	M.D.
Telephone Number	:	407-648-9500

Provider Enumeration Date	:	08/24/2007
Last Update Date	:	09/27/2010

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