Suzanne E Green PHD PA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY5213 Issued in FL

Legal business name

SUZANNE E GREEN PHD PA

Practice address

4399 N Nob Hill Rd
Sunrise, FL 33351-5813

Phone

(954) 746-8415

Fax

(954) 370-5967

NPI assigned

Jul 18, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Suzanne E Green, PHD, PANPI 1598833832

Title

President

Phone

(954) 146-8415

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Suzanne Ellen Green, PHD

  • Psychologist
  • Sunrise, FL
  • NPI 1598833832
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1851689418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 W ABIACA CIR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333287134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4399 N NOB HILL RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333515813",
            "telephone_number": "954-746-8415",
            "fax_number": "954-370-5967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZANNE E GREEN PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-146-8415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, PA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY5213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Kimberly Sures, NP-C
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• Rolando G. Sy, CRNA
• Denise Sydnor, PH.D.
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• Psychologist in Sunrise, FL
• Providers in Sunrise, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.