Green, Thomas Justin

Green, Thomas Justin is an individual health care provider with primary practice located at 1673 Mason Ave Suite 305, Daytona Beach FL 32117-5515. He recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Therapeutic Radiology, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Green, Thomas Justin can be contacted via phone (386) 274-7118.

Contact Information

Primary practice address
1673 Mason Ave Suite 305 Daytona Beach FL 32117-5515
Phone: (386) 274-7118
Fax: (386) 274-6173
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X ME 86894 Florida
Allopathic & Osteopathic Physicians / Diagnostic Ultrasound 2085U0001X ME 86894 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 103916 Georgia
Allopathic & Osteopathic Physicians / Therapeutic Radiology 2085R0203X ME 86894 Florida
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X ME 86894 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 0101102736 Virginia
Allopathic & Osteopathic Physicians / Nuclear Radiology 2085N0904X ME 86894 Florida
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X ME 86894 Florida
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X ME86894 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME86894 Florida

Profile Details

NPI number 1942207709
LBN Legal business name Green, Thomas Justin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Oct 1st, 2025 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942207709 NPPES
Florida Other 79205 BCBS OF FLORIDA
Florida MEDICAID 267313400 BCBS OF FLORIDA

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