Provider Demographics
NPI:1396890596
Name:GREENSPAN, CARRIE E (MD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:E
Last Name:GREENSPAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CARRIE
Other - Middle Name:E
Other - Last Name:GREENSPAN-PULLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1801 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8920
Mailing Address - Country:US
Mailing Address - Phone:954-345-1117
Mailing Address - Fax:954-345-9105
Practice Address - Street 1:1801 N UNIVERSITY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8920
Practice Address - Country:US
Practice Address - Phone:954-345-1117
Practice Address - Fax:954-345-9105
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51538207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04685Medicare ID - Type Unspecified
FLD03130Medicare UPIN