Debra Todd Black, D.O., P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS5735 Issued in FL

Legal business name

DEBRA TODD BLACK, D.O., P.A.

Practice address

13440 Parker Commons Blvd
Suite 101
Fort Myers, FL 33912-1816

Phone

(239) 432-9383

Fax

(239) 432-9392

NPI assigned

Jan 13, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Renee Jean Richards

Title

Office Manager

Phone

(239) 432-9383

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ricardo E Novoa, D.O.

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1720094691
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1083919500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13440 PARKER COMMONS BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121816",
            "telephone_number": "239-432-9383",
            "fax_number": "239-432-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13440 PARKER COMMONS BLVD",
            "address_2": "SUITE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121816",
            "telephone_number": "239-432-9383",
            "fax_number": "239-432-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBRA TODD BLACK, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-13",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "RICHARDS",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "239-432-9383",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Angela Debboli-Flores, P.T.
• Mark Debenedictis
• Lori Marie Deblasi, DPM
• Petra Debolt, A.R.N.P.
• Kimberly Debow, APRN
• Paul Samuel Decarlo Jr., D.D.S., P.A.
• Joaquina Decembre
• Matthew Daniel Dechene, RN
• Sarah Decker
• Dedicated Senior Medical Centers of Florida, LLC

• Family Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.