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General NPI Number Information
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NPI Number | 1831419068
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Entity Type | Individual
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Provider Name | ERIN LESSNER BLACK M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 6801 NW 9TH BLVD STE 2
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City | GAINESVILLE
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State | FL
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Zip | 32605-4263
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Country | US
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Telephone | 352-514-5829
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Fax | 864-522-3975
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Provider Business Mailing Address
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Address Line | 5408 SW 93RD TER
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City | GAINESVILLE
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State | FL
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Zip | 32608-4327
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Country | US
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Telephone | 352-514-5829
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | ME119178
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License Number State | FL
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