MEDICARE: SCOTT M. GREENBERG DO

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	207X00000X	Orthopaedic Surgery Physician	OS9310	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PENDING	OTHER	FL	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3140636	OTHER	FL	CIGNA
4	318102	OTHER	FL	AVMED
5	PENDING	OTHER	FL	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255503363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT M. GREENBERG DO

Provider Business Mailing Address
First Line	:	PO BOX 11390
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4004
Country	:	US
Telephone Number	:	866-949-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	24231 WALDEN CENTER DR STE 201
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	34134
Country	:	US
Telephone Number	:	239-348-4221
Fax Number	:	239-390-2486

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2008
Last Update Date	:	09/03/2020

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Directions to “ SCOTT M. GREENBERG DO” Practice Location

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