Provider Demographics
NPI:1366476632
Name:GREENBERG, CLIFFORD ALAN (MD)
Entity type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:ALAN
Last Name:GREENBERG
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 1:13324 POND APPLE DR W
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8556
Mailing Address - Country:US
Mailing Address - Phone:239-560-1655
Mailing Address - Fax:239-471-0763
Practice Address - Street 1:13324 POND APPLE DR W
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8556
Practice Address - Country:US
Practice Address - Phone:239-560-1655
Practice Address - Fax:239-471-0763
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92387207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAC644XOtherMEDICARE PTAN
NY01459058Medicaid
FLAC644XOtherMEDICARE PTAN
FLE94809Medicare UPIN
NY01459058Medicaid