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Individual
ALEC COLE CLARK
Active
Individual
ALEC COLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
207Q00000X
Family Medicine Physician
Primary
TRN5055
FL
207T00000X
Neurological Surgery Physician
T-5055
MS
Other
Enumeration date
03/31/2023
Last updated
10/04/2026
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