Carlie M Black (NPI# 1174047591, PAC ID# 0648537043) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1174047591 |
| PAC ID by PECOS | 0648537043 |
| Professional Enrollment ID | I20180918003194 |
| Full Name | Carlie M Black |
| Organization Legal Name | VEIN SPECIALISTS AT ROYAL PALM SQUARE INC |
| Address |
1510 Royal Palm Square Blvd Suite 101 Fort Myers FL 33919-1068 |
| Phone Number | 2396948346 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 7214001494 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3359 Woods Edge Circle, Suite 102, Bonita Springs, FL 34134-3327 | 2396948346 | VEIN SPECIALISTS AT ROYAL PALM SQUARE INC |
| 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 | 2396948346 | VEIN SPECIALISTS AT ROYAL PALM SQUARE INC |
| 799 Doctors Ct, Roxboro, NC 27573-4571 | 3365994079 | EMERGEORTHO PA |
| 4815 Oleander Dr, Suite 100, Wilmington, NC 28403-5108 | 9103323800 | EMERGEORTHO PA |
| Organization Legal Name | VEIN SPECIALISTS AT ROYAL PALM SQUARE INC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adelene Frances Tolisano | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Sharon L Spoede | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Joseph G Magnant | Vascular Surgery | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Jill Tanner | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Jill Layman | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Street Address |
1510 ROYAL PALM SQUARE BLVD SUITE 101 |
| City | FORT MYERS |
| State | FL |
| Zip | 33919-1068 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adelene Frances Tolisano | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Sharon L Spoede | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Robert M Mandelkorn | Ophthalmology | 1510 Royal Palm Square Blvd, Suite 106, Fort Myers, FL 33919-1068 | |
| Robin Thad Goodwin | Ophthalmology | 1510 Royal Palm Square Blvd, Suite 106, Fort Myers, FL 33919-1068 | |
| Joseph G Magnant | Vascular Surgery | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Jill Tanner | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Jill Layman | Nurse Practitioner | Vein Specialists At Royal Palm Square Inc | 1510 Royal Palm Square Blvd, Suite 101, Fort Myers, FL 33919-1068 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Naser Kamkar | Family Medicine | 4575 Via Royale, Suite 216, Fort Myers, FL 33919-1019 | |
| Angela M Tapia | Internal Medicine | Millennium Physician Group LLC | 4755 Summerlin Rd, Suite 8, Fort Myers, FL 33919-1073 |
| Brian G Martin | Internal Medicine | Millennium Physician Group LLC | 4755 Summerlin Rd, Suite 8, Fort Myers, FL 33919-1073 |
| Lakshmi Bushan | Internal Medicine | Millennium Physician Group LLC | 4755 Summerlin Rd, Suite 8, Fort Myers, FL 33919-1073 |
| Ann L Kurn | Nurse Practitioner | Millennium Physician Group LLC | 4755 Summerlin Rd, Suite 8, Fort Myers, FL 33919-1073 |
| Scott L Geller | Ophthalmology | 4755 Summerlin Rd, Suite 1, Fort Myers, FL 33919-1073 | |
| Norman J Arons | Optometry | 4755 Summerlin Rd, Suite 1, Fort Myers, FL 33919-1073 | |
| Cecile Saint Paul | Obstetrics/gynecology | 1412 Royal Palm Square Blvd, Suite 102, Fort Myers, FL 33919-1075 | |
| Laurie L Gutstein | Diagnostic Radiology | Radiology Alliance PC | 6013 W Riverside Dr, Fort Myers, FL 33919-1636 |
| Randal L Hanson | Optometry | 4600 Summerlin Rd, C4, Fort Myers, FL 33919-3003 | |
| Find all physicians in zip 33919 | |||
| City | FORT MYERS |
| Zip Code | 33919 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | FORT MYERS + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.