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

Dr. Angela Prevatt Black, MD

Individual provider Pediatric Otolaryngology Physician · NPI 1275793358

Dr. Angela Prevatt Black, MD is a Pediatric Otolaryngology Physician in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2008.

Licensed in
FL
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10475 Centurion Pkwy N Ste 302
Jacksonville, FL 32256-5004
Phone: (904) 398-5437
Fax: (904) 398-3077
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Otolaryngology Physician (primary) Taxonomy 207YP0228X · Licence ME115569 (FL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1275793358
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 12, 2008
Last updated in NPPESJuly 1, 2024
Certification dateJuly 1, 2024

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