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

Theresa Marie Black, APRN

Individual provider Gerontology Nurse Practitioner · NPI 1164119269

Theresa Marie Black, APRN is a Nurse Practitioner in Melbourne, Florida. Qualified in 2023, 3 years ago. Practices with Medical Associates of Brevard LLC, a 75-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
3
Licensed in
FL
In the registry since
2023
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

See every abbreviation used in this directory →

Practice location Address checks out

402 N Babcock St Ste 102
Melbourne, FL 32935-7335
Phone: (321) 241-6540
Fax: (321) 428-4442
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence APRN11025876 (FL)

Record details

NPI number1164119269
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorYes
NPI enumeratedApril 19, 2023
Last updated in NPPESApril 19, 2023
Certification dateApril 19, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Medical Associates Of Brevard Llc — 75 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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