Individual
MICHAEL B. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1613 HARRISON PKWY, #200, SUNRISE, FL 33323-2853
(954) 838-2371
(951) 851-1758
Mailing address
12598 PINK MYRTLE CT, BOYNTON BEACH, FL 33473-7127
(954) 288-6500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME81928
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260780800
—
FL
Enumeration date
02/14/2006
Last updated
12/14/2021
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