Individual
CONNOR BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316-2510
(954) 355-4400
Mailing address
2452 NW COLUMBIA AVE UNIT 11, EAST WENATCHEE, WA 98802-4198
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4451
AL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
04/24/2026
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