Organization
DOUGLAS K BLACK OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOREEN J DEGIROLAMO (BILLING MANAGER)
(941) 751-6583
Entity
Organization
Contact information
Practice address
5350 GULF OF MEXICO DR, SUITE 202, LONGBOAT KEY, FL 34228-2069
(941) 387-8772
(941) 387-8779
Mailing address
5350 GULF OF MEXICO DR, SUITE 202, LONGBOAT KEY, FL 34228-2069
(941) 387-8772
(941) 387-8779
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3563
FL
Other
Enumeration date
11/29/2007
Last updated
01/10/2008
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