| Doctor Name: | LAWRENCE GREEN |
| NPI Number: | 1104231570 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | 9344187 |
| Business Practice Address: | 6509 Nw 105th Ave Alachua, FL - 326157448 |
| Business Phone Number: | 9096598184 |
| Business Fax Number: | |
| Mailing Address: | 6509 Nw 105th Ave, ALACHUA |
| State: | FL |
| Postal Code: | 326157448 |
| Phone Number: | 9096598184 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2014 |
| NPI Last Update Date: | 06/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0100X |
| License Number: | 9344187 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Gastroenterology |
| Taxonomy Definition: | |