| Greenbrook Medical Practice, PLLC | |
|
11200 E Dr Martin Luther King Jr Blvd Ste 107 Seffner FL 33584-8351 | |
| (813) 443-3399 | |
| Not Available |
| Full Name | Greenbrook Medical Practice, PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 11200 E Dr Martin Luther King Jr Blvd Ste 107, Seffner, Florida |
| Authorized Official Name and Position | Raj Machhar (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 8134433399 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenbrook Medical Practice, PLLC 11200 E Dr Martin Luther King Jr Blvd Ste 107 Seffner FL 33584-8351 Ph: (813) 443-3399 | Greenbrook Medical Practice, PLLC 11200 E Dr Martin Luther King Jr Blvd Ste 107 Seffner FL 33584-8351 Ph: (813) 443-3399 |
| NPI Number | 1457014342 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 08/02/2026 |
| Certification Date | 08/02/2026 |
| Medicare PECOS PAC ID | 5092105627 |
|---|---|
| Medicare Enrollment ID | O20211214000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457014342 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Manish B Baria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235111519 PECOS PAC ID: 7113995572 Enrollment ID: I20040922001235 |
| Provider Name | Abhishek Gulati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205284288 PECOS PAC ID: 0143550830 Enrollment ID: I20190923002849 |
| Provider Name | Raj Prakash Machhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972948701 PECOS PAC ID: 7214229855 Enrollment ID: I20211214000680 |
| Provider Name | Aida R Berdasco Paz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1801820543 PECOS PAC ID: 5496990152 Enrollment ID: I20230505000973 |
| Provider Name | Daniel E Diez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790314177 PECOS PAC ID: 5698131647 Enrollment ID: I20230517000111 |
| Provider Name | Shereen Naccour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003499898 PECOS PAC ID: 0941731897 Enrollment ID: I20241002001457 |
| Provider Name | Leila Shafiq |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962142125 PECOS PAC ID: 4183146822 Enrollment ID: I20250321002442 |
| Provider Name | Howard Henry Farrington |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538268354 PECOS PAC ID: 1759423809 Enrollment ID: I20250721000041 |
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