Provider Demographics
NPI:1285712117
Name:GREENE, JOEL L (RPH CPH)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:L
Last Name:GREENE
Suffix:
Gender:M
Credentials:RPH CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8095 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2602
Mailing Address - Country:US
Mailing Address - Phone:954-575-8230
Mailing Address - Fax:954-575-8235
Practice Address - Street 1:8095 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-2602
Practice Address - Country:US
Practice Address - Phone:954-575-8230
Practice Address - Fax:954-575-8235
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19429183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist