Provider Demographics
NPI:1316051162
Name:CARROLL, BRIGGS GREENE (MD)
Entity type:Individual
Prefix:DR
First Name:BRIGGS
Middle Name:GREENE
Last Name:CARROLL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 CATTLEMEN RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6283
Mailing Address - Country:US
Mailing Address - Phone:941-955-8319
Mailing Address - Fax:941-366-7582
Practice Address - Street 1:2020 CATTLEMEN RD
Practice Address - Street 2:SUITE 600
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6283
Practice Address - Country:US
Practice Address - Phone:941-955-8319
Practice Address - Fax:941-366-7582
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 80716208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH78556Medicare UPIN