Individual
DR. JANET L BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
3651 LAKE CENTER DR, MOUNT DORA, FL 32757-2364
(352) 385-9156
(352) 385-9159
Mailing address
3651 LAKE CENTER DR, MOUNT DORA, FL 32757-2364
(352) 385-9156
(352) 385-9159
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
PO1752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480028889
RAILROAD MEDICARE
FL
01
—
87999
BCBS PROVIDER ID
FL
Enumeration date
10/20/2005
Last updated
02/16/2009
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