Individual
DR. THOMAS J BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10000 BAY PINES BLVD, BAY PINES VAMC, BAY PINES, FL 33744
(727) 398-6661
(727) 398-9575
Mailing address
POBOX 5005, BAY PINES VAMC 114, BAY PINES, FL 33744
(727) 398-6661
(727) 398-9575
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME36561
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME36561
FL
Other
Enumeration date
03/22/2006
Last updated
12/18/2007
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