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Individual
KATHERINE BLACK
Active
Individual
KATHERINE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME157028
FL
208M00000X
Hospitalist Physician
ME157028
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115059300
—
FL
01
—
TF0ZU
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/25/2019
Last updated
08/12/2024
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