Organization
JANET L BLACK D P M P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET L BLACK DPM (OWNER)
(352) 385-9156
Entity
Organization
Contact information
Practice address
3651 LAKE CENTER DR, MOUNT DORA, FL 32757-2364
(352) 385-9156
(352) 385-9159
Mailing address
3651 LAKE CENTER DR, MOUNT DORA, FL 32757-2364
(352) 385-9156
(352) 385-9159
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891844270
MEDICARE
FL
01
—
DF7049
RAILROAD MEDICARE
FL
Enumeration date
01/09/2007
Last updated
06/25/2015
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