Green, Pamela
Green, Pamela is an sole proprietor health care provider with primary practice located at 11325 Lake Underhill Rd Ste 101 , Orlando FL 32825-5090. She recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Forensic, Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Green, Pamela can be contacted via phone (407) 365-2599.Contact Information
Primary practice address
11325 Lake Underhill Rd Ste 101
Orlando FL 32825-5090
Phone: (407) 365-2599
Fax: (407) 365-3132
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | PY0002246 | Florida |
| Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X | PY0002246 | Florida |
| Behavioral Health & Social Service Providers / Forensic | 103TF0200X | PY0002246 | Florida |
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X | PY0002246 | Florida |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PY0002246 | Florida |
Profile Details
| NPI number | 1487873717 |
|---|---|
| LBN Legal business name | Green, Pamela |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 25th, 2007 |
| Last updated | Feb 7th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487873717 | NPPES |
| Florida | MEDICAID | 009418900 | |
| Florida | MEDICAID | 209749400 |
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