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Individual

ALEC COLE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15048 14TH ST, DADE CITY, FL 33523-2503
(352) 232-8997
(833) 422-0029
Mailing address
15048 14TH ST, DADE CITY, FL 33523-2503
(352) 232-8997
(833) 422-0029

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
207T00000X
Neurological Surgery Physician
T-5055
MS

Other

Enumeration date
03/31/2023
Last updated
09/17/2025
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