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Individual
MERIDITH JILL CLARK
Active
Individual
MERIDITH JILL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101273
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292255000
—
FL
01
—
P00210547
MEDICARE RR
FL
Enumeration date
09/06/2005
Last updated
10/16/2025
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