Green Lake Village Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GREEN LAKE VILLAGE INC

Practice address

1107 E Jackson St Ste 208
Tampa, FL 33602-4161

Phone

(813) 280-1199

NPI assigned

Oct 8, 2024

Organization subpart

No

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

Authorized official

Name

Ricardo Rodriquez Figueroa

Title

Owner

Phone

(813) 280-1199

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ricardo Rodriguez Figueroa

  • Durable Medical Equipment & Medical Supplies
  • Tampa, FL
  • NPI 1174375125
  NPD

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

{
    "created_epoch": "1728345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1790504694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 E JACKSON ST STE 208",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024161",
            "telephone_number": "813-280-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 E JACKSON ST STE 208",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024161",
            "telephone_number": "813-280-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LAKE VILLAGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "RODRIQUEZ FIGUEROA",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-280-1199"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Marie Grebinger
• Alexis Nicole Grecco
• Grecia S Ibarra Aprn LLC
• Cherice Greco, PSY. S.
• James L Greco Jr., OD
• Green Lightening Healthcare
• Green Pasture Psychiatry LLC
• Green Senior Care of Tampa LLC
• Gavril S Green-Goodman, ARNP
• Adam S Green, MD

• Durable Medical Equipment & Medical Supplies in Tampa, FL
• Providers in Tampa, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.

Verify at the official NPI Registry.