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Individual
MELISSA L BLACK
Active
Individual
MELISSA L BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3430
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20978
BLUE CROSS BLUE SHIELD
FL
05
—
620639500
—
FL
01
—
6484136
CIGNA
FL
01
—
7128254
AETNA
FL
Enumeration date
05/12/2006
Last updated
06/05/2012
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