Tisari Black
Nurse Practitioner, Psych/Mental Health in Coral Springs, FL. Individual provider (NPI-1).
NPI number1508790163
StatusActive
Last updated in NPPESJun 10, 2026
Details
- NPI
- 1508790163
- Entity type
- Individual (NPI-1)
- Name
- Tisari Black
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2026
- Certification date
- Jun 10, 2026
- Last updated
- Jun 10, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | APRN11048198 | FL | Yes |
Practice location
845 Nw 126th DrCoral Springs, FL 33071-4428
Phone 786-538-5296
Mailing address
845 Nw 126th DrCoral Springs, FL 33071-4428
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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