Black, Janis G

Black, Janis G is an sole proprietor health care provider with primary practice located at 3740 Curtis Blvd Suite 108, Cocoa FL 32927-3962. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Black, Janis G can be contacted via phone (321) 633-5500.

Contact Information

Primary practice address
3740 Curtis Blvd Suite 108 Cocoa FL 32927-3962
Phone: (321) 633-5500
Fax: (321) 633-5566
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS9694 Florida

Profile Details

NPI number 1699721548
LBN Legal business name Black, Janis G
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 25th, 2006
Last updated Feb 25th, 2013 - about 12 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 1699721548 NPPES
Florida MEDICAID 275301400
Florida Other 52558
Florida Other 8727208
Florida Other 7615827

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