Black, Suellen M

Black, Suellen M is an individual health care provider with primary practice located at 4506 N Armenia Ave , Tampa FL 33603-2732. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Black, Suellen M can be contacted via phone (813) 879-3530.

Contact Information

Primary practice address
4506 N Armenia Ave Tampa FL 33603-2732
Phone: (813) 879-3530
Fax: (813) 874-6608
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 364SP0200X 9347255 Florida

Profile Details

NPI number 1770835233
LBN Legal business name Black, Suellen M
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 9th, 2012
Last updated Oct 9th, 2012 - 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 1770835233 NPPES
Florida Other ARNP9347255 ARNP LICENSE

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