Individual
MRS. DEBRA TODD BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
13440 PARKER COMMONS BLVD, STE 101, FORT MYERS, FL 33912-1816
(239) 432-9383
(239) 432-9392
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS 5735
FL
Other
Enumeration date
07/24/2006
Last updated
02/06/2024
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