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:
Health care specialties
Specialty | Code | License # | 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 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699721548 | NPPES |
Florida | MEDICAID | 275301400 | |
Florida | Other | 52558 | |
Florida | Other | 8727208 | |
Florida | Other | 7615827 |
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