Organization
LAWRENCE R. BLACK, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN DESANTIS (OFFICE MANAGER)
(239) 768-5313
Entity
Organization
Contact information
Practice address
13691 METRO PKWY, SUITE 350, FORT MYERS, FL 33912-4327
(239) 768-5313
(239) 768-9559
Mailing address
13691 METRO PKWY, SUITE 350, FORT MYERS, FL 33912-4327
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS5736
FL
Other
Enumeration date
05/29/2007
Last updated
04/03/2013
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