Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Connor Black, DO

Individual provider Emergency Medicine Physician · NPI 1669176160

Connor Black, DO is an Emergency Medicine in Fort Lauderdale, Florida. Qualified in 2023, 3 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Alabama and Kentucky.

Years since qualifying
3
Licensed in
AL, KY
In the registry since
2023
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1600 S Andrews Ave
Fort Lauderdale, FL 33316-2510
Phone: (954) 355-4400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 06250 (KY)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 4451 (AL)

Record details

NPI number1669176160
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMarch 28, 2023
Last updated in NPPESMay 11, 2026
Certification dateMay 11, 2026
Mailing address2452 Nw Columbia Ave Unit 11, East Wenatchee, WA 98802-4198

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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