Black, Lisa Breaux

Black, Lisa Breaux is an sole proprietor health care provider with primary practice located at 161 N Causeway Ste A , New Smyrna Beach FL 32169-5328. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Black, Lisa Breaux can be contacted via phone (386) 424-1584.

Contact Information

Primary practice address
161 N Causeway Ste A New Smyrna Beach FL 32169-5328
Phone: (386) 424-1584
Fax: (386) 410-4800
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22558 Louisiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME164904 Florida

Profile Details

NPI number 1851484307
LBN Legal business name Black, Lisa Breaux
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2006
Last updated Apr 3rd, 2026 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851484307 NPPES
Louisiana MEDICAID 1490466

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