Charla Jean Green, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MM13301 Issued in FL

Practice address

601 E Strawbridge Ave
Melbourne, FL 32901-4733

Phone

(321) 984-7967

NPI assigned

Sep 15, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253491200000",
    "number": "1447583943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2553 AMBERLY RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329052740",
            "telephone_number": "321-984-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E STRAWBRIDGE AVE",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329014733",
            "telephone_number": "321-984-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHARLA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MM13301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Gray, D.C.
• Michael Graziani
• Michele Lee Graziani, PHARMD
• Gabriella Graziano-Lo Presti
• Sydney Graziosi, LCSW
• Douglas Green, M.D.
• Felicia Green
• Mary Alice Green, LMHC
• Mitchell R Greenberg, D.C.
• Jennifer Greene, APRN

• Specialist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.