LAWRENCE R. BLACK, D.O., P.A.
Medical Practice at Metro Pkwy, Fort Myers, FL

License number
Florida OS5736
Category
Medical Practice
Type
Specialist
Owner
Name: KAREN DESANTIS
Title: OFFICE MANAGER
Phone: (239) 768-5313
Address
Address
13691 Metro Pkwy SUITE 350, Fort Myers, FL 33912
National Provider ID: 1619178654
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about LAWRENCE R. BLACK, D.O., P.A. at bizstanding.com

Lawrence R. Black, D.O., PA

Brandon, FL  -  Fort Myers, FL

Status:
Inactive
Registration:
Dec 21, 1995
Addresses:
1333 Providence Rd, Brandon, FL 33511
13691 Metro Pkwy, Fort Myers, FL 33912
State ID:
P95000096577
Business type:
Domestic for Profit Corporation
President, Treasurer, Secretary, Director:
Lawrence R. Black President, Treasurer, Secretary, Director, inactive

Medical Practice licenses in Florida










Other Doctors licenses in Florida