Individual
DR. DOUGLAS KEITH BLACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5350 GULF OF MEXICO DR, SUITE #202, LONGBOAT KEY, FL 34228-2069
(941) 387-8772
Mailing address
1872 CHIMNEY CREEK PL, SARASOTA, FL 34235-1820
(941) 342-1363
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC-3563
FL
Other
Enumeration date
06/09/2006
Last updated
07/08/2007
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