Doctor Name: | MS. CAROL ANN BLACK |
NPI Number: | 1942466537 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | |
Business Practice Address: | 903 E Cypress Creek Rd Ft Lauderdale, FL - 333344116 |
Business Phone Number: | 9544912225 |
Business Fax Number: | 9544916862 |
Mailing Address: | 1419 S 24th Ct, HOLLYWOOD |
State: | FL |
Postal Code: | 330205803 |
Phone Number: | 9546964978 |
Fax Number: | |
NPI Enumeration Date: | 08/02/2008 |
NPI Last Update Date: | 08/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |