Individual
DR. GREGORY SCOTT BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3200 S UNIVERSITY DR, NSU COLLEGE OF OPTOMETRY SUITE 1402, DAVIE, FL 33328-2018
(954) 262-1402
(954) 262-1818
Mailing address
881 CAMELLIA CT, PLANTATION, FL 33317-1350
(954) 581-7291
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2975
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
620573900
—
FL
Enumeration date
10/27/2006
Last updated
07/08/2007
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