Provider Demographics
NPI:1881626521
Name:GREIF, STUART J (PSYD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:J
Last Name:GREIF
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 E KNIGHTS GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33565-2217
Mailing Address - Country:US
Mailing Address - Phone:813-754-1105
Mailing Address - Fax:
Practice Address - Street 1:6700 S FLORIDA AVE
Practice Address - Street 2:SUITE 13
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3327
Practice Address - Country:US
Practice Address - Phone:863-648-0500
Practice Address - Fax:863-644-9015
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 3817103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73497Medicare ID - Type Unspecified