Individual
BRIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 259-8510
Mailing address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 250-2506
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME150236
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2017
Last updated
08/06/2024
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