Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles C Greene MD PHD PA

Organization Otolaryngology Physician · NPI 1457600769

Charles C Greene MD PHD PA is an Otolaryngology Physician in Jacksonville, Florida. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11512 Lake Mead Ave Ste 531
Jacksonville, FL 32256-9733
Phone: (904) 419-2054
Fax: (904) 419-2057
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X

Record details

NPI number1457600769
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Greene — Owner · (904) 419-2054
Other names Jacksonville Ent Surgery Center; Jacksonville Ent Surgery Center
NPI enumeratedAugust 31, 2012
Last updated in NPPESAugust 3, 2022
Certification dateAugust 3, 2022
Mailing address11512 Lake Mead Ave Unit 531, Jacksonville, FL 32256-9733

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