THERESA MARIE BLACK

MELBOURNE, FL
NPI1164119269
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: FL  APRN11025876)
Enumeration Date2023-04-19
Last Update Date2023-04-19
Business Address
THERESA MARIE BLACK APRN
402 N BABCOCK ST STE 102
MELBOURNE, FL 32935-7335
Phone number: 321-241-6540
Mailing Address
THERESA MARIE BLACK APRN
PO BOX 361095
MELBOURNE, FL 32936-1095
Phone number: 321-253-2900
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