# MELISSA L BLACK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1457301921
- **Gender:** F
- **Credential:** OD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC3430 | FL | Yes |

## Other

- **Enumeration date:** 05/12/2006
- **Last updated:** 06/05/2012

## 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 |