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Individual
DR. JANIS G BLACK
Active
Individual
DR. JANIS G BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS9694
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275301400
—
FL
01
—
52558
BLUE CROSS BLUE SHIELD
FL
01
—
7615827
AETNA
FL
01
—
8727208
CIGNA
FL
Enumeration date
05/25/2006
Last updated
02/25/2013
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