Organization
CHAD BLACK MD, LLC
Active
Parent organization
TOWN CENTER FAMILY MEDICINE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
TOWN CENTER FAMILY MEDICINE LLC
Authorized official
CHAD BLACK MD (CEO / MEDICAL DIRECTOR)
(321) 287-6955
Entity
Organization
Contact information
Practice address
610 SYCAMORE STREET SUITE 130, CELEBRATION, FL 34747
(321) 287-6955
Mailing address
610 SYCAMORE STREET SUITE 130, CELEBRATION, FL 34747
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
FL
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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