Basic Information
| Provider Information | |||||||||
| NPI: | 1275768889 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DAINA P GREENE MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 694 NW SAVANNAH CIR | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320556880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867550500 | ||||||||
| FaxNumber: | 3867559217 | ||||||||
| Practice Location | |||||||||
| Address1: | 449 SE BAYA DR | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 320256022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3867550500 | ||||||||
| FaxNumber: | 3867559217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2009 | ||||||||
| LastUpdateDate: | 05/27/2009 | ||||||||
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| AuthorizedOfficialLastName: | GREENE | ||||||||
| AuthorizedOfficialFirstName: | DAINA | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 3867550500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | FL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.