Dr. Angela Prevatt Black
Pediatric Otolaryngology
807 Childrens Way Nemours Childrens Clinic,
Jacksonville
, Florida 32207-8426
Dr. Angela Prevatt Black
Pediatric Otolaryngology
807 Childrens Way Nemours Childrens Clinic,
Jacksonville
, Florida 32207-8426
(302) 651-4945
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About
Features
Specialties
- Pediatric Otolaryngology
Languages spoken
- English
Location
First Address
- Dr. Angela Prevatt Black
- Po Box 191 Provider Enrollment Department,
- Rockland, DE
- Zip : 19732-0191
- Fax : (302) 651-4945
- Phone : (302) 651-4488
Second Address
- Dr. Angela Prevatt Black
- 807 Childrens Way Nemours Childrens Clinic,
- Jacksonville, FL
- Zip : 32207-8426
- Fax : (904) 697-3792
- Phone : (904) 697-3600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YP0228X | Pediatric Otolaryngology | ME115569 | FL |
National Provider Identifier
| NPI | 1275793358 |
|---|---|
| Provider Name | Dr. Angela Prevatt Black |
| First Address | Rockland, DE 19732-0191 |
| Second Address | Jacksonville, FL 32207-8426 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/06/2008 |
| Last Update Date | 16/09/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| '009304000 | (05) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.