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NPI Code Detail

MEDICARE: MR. JAVON BAXTER GREEN

MEDICARE: MR. JAVON BAXTER 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
1247200000XOther Technician

General Provider Information

NPI Number : 1497602288
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAVON BAXTER GREEN
Provider Business Mailing Address
First Line : 4575 SE DIXIE HWY
Second Line :
City : STUART
State : FL
Zip : 34997-6826
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 525 N TRYON ST STE 1600
Second Line :
City : CHARLOTTE
State : NC
Zip : 28202-0213
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “ MR. JAVON BAXTER GREEN ” Practice Location

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