| Suzanne E Green Phd Pa | |
|
4399 N Nob Hill Rd Sunrise FL 33351-5813 | |
| (954) 746-8415 | |
| (954) 370-5967 |
| Full Name | Suzanne E Green Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 4399 N Nob Hill Rd, Sunrise, Florida |
| Authorized Official Name and Position | Suzanne E Green (PRESIDENT) |
| Authorized Official Contact | 9541468415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suzanne E Green Phd Pa 2921 W Abiaca Cir Davie FL 33328-7134 Ph: () - | Suzanne E Green Phd Pa 4399 N Nob Hill Rd Sunrise FL 33351-5813 Ph: (954) 746-8415 |
| NPI Number | 1851689418 |
|---|---|
| Provider Enumeration Date | 07/18/2011 |
| Last Update Date | 11/29/2011 |
| Medicare PECOS PAC ID | 4486828555 |
|---|---|
| Medicare Enrollment ID | O20111130000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851689418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY5213 (Florida) | Primary |
| Provider Name | Suzanne E Green |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598833832 PECOS PAC ID: 6507030681 Enrollment ID: I20120104000185 |
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