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NPI Code Detail

MEDICARE: ERRITY GREEN

MEDICARE: ERRITY GREEN
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
1103K00000XBehavior Analyst

Other Identifiers

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

General Provider Information

NPI Number : 1366757817
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERRITY GREEN
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1413 TECH BLVD STE 122
Second Line :
City : TAMPA
State : FL
Zip : 33619-7822
Country : US
Telephone Number : 941-264-8135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2010
Last Update Date : 04/22/2022

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Directions to “ ERRITY GREEN ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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