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1629159223
VIRGINIA GIBSON BLACK
JACKSONVILLE, FL
NPI
1629159223
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: FL ME78245)
Enumeration Date
2006-10-18
Last Update Date
2018-12-28
Business Address
VIRGINIA GIBSON BLACK M.D.
14810 OLD SAINT AUGUSTINE RD STE 106 CREDENTIALING DEPARTMENT
JACKSONVILLE, FL 32258-2558
Phone number: 904-268-7701
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Mailing Address
VIRGINIA GIBSON BLACK M.D.
PO BOX 45443
SALT LAKE CITY, UT 84145-0443
Phone number: 904-202-1032
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