person
Dr. Michael Robert Black, DPM
Foot & Ankle Surgery Podiatrist in Fort Myers, Florida
NPI 1851589055

Michael Robert Black is a Foot & Ankle Surgery Podiatrist based in Fort Myers, FL and is specialized in Foot & Ankle Surgery. Michael Robert Black practices in Fort Myers, FL and has the professional credentials of DPM. The NPI Number for Michael Robert Black is 1851589055 and holds a License No. PL00000830 (Florida).

The current practice location address for Michael Robert Black is 12670 Creekside Ln, Fort Myers, FL and can be reached out via phone at 239-482-2663 and via fax at 239-482-7585. You can also correspond with Michael Robert Black through the mailing address at 12670 CREEKSIDE LN STE 202, FORT MYERS, FL - 33919-3370 (mailing address contact number: 239-482-2663).

Location: 12670 Creekside Ln, Fort Myers, FL, 33919-3370
person
Provider Profile Details
NPI Number
1851589055
Provider Name
Michael Robert Black
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
12670 Creekside Ln, Fort Myers, FL, 33919-3370
Phone Number
239-482-2663
Fax Number
239-482-7585
Provider Enumeration Date
10/12/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
DJ551Y 01 FL MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
12670 Creekside Ln
City
State
Zip
33919-3370
Phone Number
239-482-2663
Fax Number
239-482-7585
person
Provider Business Mailing Address Details
Address
12670 Creekside Ln
City
State
Zip
33919-3370
Phone Number
239-482-2663
Fax Number
239-482-7585
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
PL00000830 (Washington)
Definition
Definition to come...
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