Black, Brian Edward

Black, Brian Edward is an individual health care provider with primary practice located at 1611 Nw 12Th Ave , Miami FL 33136-1005. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery is his primary health care specialty. Black, Brian Edward can be contacted via phone (305) 585-5881.

Contact Information

Primary practice address
1611 Nw 12Th Ave Miami FL 33136-1005
Phone: (305) 585-5881
Fax: (305) 585-3322
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 31096 Wisconsin
Allopathic & Osteopathic Physicians / Sports Medicine 2080S0010X 31096 Wisconsin
Allopathic & Osteopathic Physicians / Pediatric Orthopaedic Surgery 207XP3100X ME138640 Florida
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 31096 Wisconsin

Profile Details

NPI number 1649269473
LBN Legal business name Black, Brian Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 14th, 2005
Last updated Jun 15th, 2021 - about 3 years ago

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 1649269473 NPPES
Wisconsin MEDICAID 31606600

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