Individual
DR. BRENDAN CHRISTIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3601 SW 160TH AVE, SUITE 250, MIRAMAR, FL 33027-6308
(877) 866-7123
(877) 671-0915
Mailing address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(404) 752-1500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2016-02441
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2011
Last updated
01/09/2017
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