Basic Information
| Provider Information | |||||||||
| NPI: | 1851369052 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREENFIELD | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | LEWIS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 8TH AVE W | ||||||||
| Address2: | STE 101 | ||||||||
| City: | PALMETTO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342214737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417764008 | ||||||||
| FaxNumber: | 9418454963 | ||||||||
| Practice Location | |||||||||
| Address1: | 404 7TH ST W | ||||||||
| Address2: | |||||||||
| City: | PALMETTO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342215209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417293856 | ||||||||
| FaxNumber: | 9417293857 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 03/24/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME38040 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 197618 | 01 | FL | AMERIGROUP | OTHER | 268550700 | 05 | FL | MEDICAID | P00188416 | 01 | FL | RAILROAD | OTHER | 28492 | 01 | FL | WELLCARE | OTHER | P102057 | 01 | FL | FREEDOM HEALTH | OTHER | 00868 | 01 | FL | UNIVERSAL | OTHER | 79621 | 01 | FL | BCBS | OTHER |