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DR. DANIEL ALEXANDER BLACK DPM

Foot & Ankle Surgery >> Podiatrist >> Podiatric Medicine & Surgery Service Providers

Registrant NPI Number: 1407298987

Individual Registrant:
DR. DANIEL ALEXANDER BLACK DPM
Gender: M
Sole Proprietor

Location and contact information for practice:
113 NATURE WALK PKWY UNIT 105 SAINT AUGUSTINE, FL 32092-3066 US
Tel: 315-382-5910  Fax: --

Contact information for business:
113 NATURE WALK PKWY UNIT 105 SAINT AUGUSTINE, FL 32092-3066 US
Tel: 315-382-5910  Fax: --

Registration Information:
NPI: 1407298987
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y213ES0103XPodiatric Medicine & Surgery Service Providers
Podiatrist
Foot & Ankle Surgery
FLPO3782

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
LICENSEPO3782FL01




HEALTH CARE JOBS FL - Page 1



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