Provider Demographics
NPI:1710863634
Name:GREEN, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18311 HIGHWOODS PRESERVE PKWY UNIT 7304
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1927
Mailing Address - Country:US
Mailing Address - Phone:407-330-8945
Mailing Address - Fax:
Practice Address - Street 1:18311 HIGHWOODS PRESERVE PKWY UNIT 7304
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1927
Practice Address - Country:US
Practice Address - Phone:407-330-8945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer