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Organization

BLACK STALLION WALK-IN AND EXERCISE MEDICINE CLINICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACIA PIERRE-PIERRE MD (OWNER)
(772) 932-9310
Entity
Organization

Contact information

Practice address
9955 SE FEDERAL HWY, HOBE SOUND, FL 33455-4829
(772) 932-9310
Mailing address
9955 SE FEDERAL HWY, HOBE SOUND, FL 33455-4829
(772) 932-9310

Taxonomy

Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13595686
CAQH
FL
Enumeration date
04/13/2020
Last updated
04/13/2020
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