Active NPI
Geno Green
- Athletic Trainer
- Hollywood, FL
National Provider Identifier
1265295109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 1908836
- Practice address
- 3500 Washinton St
Apt 210
Hollywood, FL 33021 - Phone
- (215) 971-5121
- NPI assigned
- Feb 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 1908836 | FL | Primary |
Addresses
Primary practice location
3500 Washinton St
Apt 210
Hollywood, FL 33021
Mailing address
3500 Washinton St
Apt 210
Hollywood, FL 33021
Phone (215) 971-5121
Other practice location 1
19333 W Country Club Dr
Aventura, FL 33180-2485
Phone (215) 971-5121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1908836 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706832000000",
"number": "1265295109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3500 WASHINTON ST",
"address_2": "APT 210",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "215-971-5121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 WASHINTON ST",
"address_2": "APT 210",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "215-971-5121"
}
],
"practiceLocations": [
{
"address_1": "19333 W Country Club Dr",
"address_purpose": "LOCATION",
"city": "Aventura",
"state": "FL",
"postal_code": "331802485",
"country_code": "US",
"telephone_number": "215-971-5121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "GENO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-02",
"last_updated": "2024-02-02",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "1908836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.