Paradise Black, Nicole Maureen
Paradise Black, Nicole Maureen is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is her primary health care specialty. Paradise Black, Nicole Maureen can be contacted via phone (352) 273-6563.Contact Information
Primary practice address
1600 Sw Archer Rd
Gainesville FL 32610-3003
Phone: (352) 273-6563
Fax: (352) 273-6250
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME93613 | Florida |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | ME93613 | Florida |
Profile Details
| NPI number | 1215961198 |
|---|---|
| LBN Legal business name | Paradise Black, Nicole Maureen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Oct 23rd, 2023 - about 3 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215961198 | NPPES |
| Florida | MEDICAID | 273313700 |
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