Provider Demographics
NPI:1124800602
Name:BLACK, HELENE (RN, APRN)
Entity type:Individual
Prefix:MS
First Name:HELENE
Middle Name:
Last Name:BLACK
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:
Other - First Name:HELENE
Other - Middle Name:
Other - Last Name:AUDOIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4924 SOLIMARTIN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4767
Mailing Address - Country:US
Mailing Address - Phone:910-333-4644
Mailing Address - Fax:
Practice Address - Street 1:5730 HAMLIN GROVES TRL STE 164
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5792
Practice Address - Country:US
Practice Address - Phone:407-347-7052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11028757207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine