Individual provider · Type 1 NPI

Katrina D. Black, PA

Medical Physician Assistant · Tampa, FL

NPI number 1801194972 Active

Practice location

3345 S Dale Mabry Hwy
Tampa, FL 33629-7817

Mailing address

10800 Brighton Bay Blvd NE Apt 3104
St. Petersburg, FL 33716-3490

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X004612 (GA)
Medical Physician Assistant Primary 363AM0700XPA9110311 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1801194972

Katrina D. Black, PA's National Provider Identifier is 1801194972, issued on Mar 14, 2011. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Tampa, FL. The record was last updated on Aug 6, 2021.